Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical s...Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical safe medication.Methods The cases and ADR reports of the three Chinese patent medicines and three herbal formulas in PubMed,Web of Science,Springer Link,CNKI,Wanfang and VIP database were retrieved from December 2019 to May 2021.Then we extracted and analyzed the effective information included in the literature.Results and Conclusion According to the pre-developed retrieval plan,a total of 136 documents were obtained,and a total of 6 documents met the inclusion criteria finally.553 patients used three Chinese patent medicines and three herbal formulas,and there were 133 cases of adverse reactions.The adverse reactions of patients taking the three Chinese patent medicines and three herbal formulas can all be explained under the theory of traditional Chinese medicine,and the adverse reactions can be eliminated by adding or subtracting the flavor of the medicine or stopping the medicine.展开更多
Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analy...Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.展开更多
Immune checkpoint inhibitors(ICPI)have shown considerable promise in the treatment of tumors.However,immune-related adverse events(irAEs)caused by ICPI have been reported in nearly every organ system.Whilst this repre...Immune checkpoint inhibitors(ICPI)have shown considerable promise in the treatment of tumors.However,immune-related adverse events(irAEs)caused by ICPI have been reported in nearly every organ system.Whilst this represents a new challenge in the field of cancer treatment,traditional Chinese medicine(TCM)provides benefits in the treatment of irAEs.This article reviews the studies of the treatment of immune-related gastrointestinal diseases and dermatosis with TCM and introduces the collaborative efforts between China and France in the implementation of TCM for the treatment of irAEs.展开更多
Chromatographic fingerprinting has been perceived as an essential tool for assessing quality and chemical equivalence of traditional Chinese medicine.However,this pattern-oriented approach still has some weak points i...Chromatographic fingerprinting has been perceived as an essential tool for assessing quality and chemical equivalence of traditional Chinese medicine.However,this pattern-oriented approach still has some weak points in terms of chemical coverage and robustness.In this work,we proposed a multiple reaction monitoring(MRM)-based fingerprinting method in which approximately 100 constituents were simultaneously detected for quality assessment.The derivative MRM approach was employed to rapidly design MRM transitions independent of chemical standards,based on which the large-scale fingerprinting method was efficiently established.This approach was exemplified on QiShenYiQi Pill(QSYQ),a traditional Chinese medicine-derived drug product,and its robustness was systematically evaluated by four indices:clustering analysis by principal component analysis,similarity analysis by the congruence coefficient,the number of separated peaks,and the peak area proportion of separated peaks.Compared with conventional ultraviolet-based fingerprints,the MRM fingerprints provided not only better discriminatory capacity for the tested normal/abnormal QSYQ samples,but also higher robustness under different chromatographic conditions(i.e.,flow rate,apparent pH,column temperature,and column).The result also showed for such large-scale fingerprints including a large number of peaks,the angle cosine measure after min-max normalization was more suitable for setting a decision criterion than the unnormalized algorithm.This proof-of-concept application gives evidence that combining MRM technique with proper similarity analysis metrices can provide a highly sensitive,robust and comprehensive analytical approach for quality assessment of traditional Chinese medicine.展开更多
Aims: To study RBL-2H3 cell degranulation phenomena induced by some TCMIs through cell morphological and ultra-structural observation, released enzyme activity and establish RBL-2H3 cell degranulation test indicated ...Aims: To study RBL-2H3 cell degranulation phenomena induced by some TCMIs through cell morphological and ultra-structural observation, released enzyme activity and establish RBL-2H3 cell degranulation test indicated by β- hexosaminidase activity as a method to evaluate TCMIs at nonclinical stage. Methods: RBL-2H3 cells were used to study the degranulation by co-culture with positive control C48/80 and some TCMIs through morphological and ultra-structure observation, β-hexosaminidase activity detection. RBL-2H3 cell degranulation test was established to detect β-hexosaminidase activity caused by 17 kinds of TCMIs and their ingredients. The cytotoxicity effect of some TCMIs on both RBL 2H3 and BRL cells was measured by CCK-8 assay. Results: Toluidine blue staining and ultra-structure of electronic microscope observation of treated RBL-2H3 cells showed degranulation morphologically. Detection of β-hexosaminidase activity in the supernatant of treated cells showed some TCMIs had elevated enzyme release rates. Further analysis of the ingredients and compound in Tanreqing Injection and Shengmai Injection showed Scutellaria baicalensis Georgi in Tanreqing Injection, Red ginseng and Fructus Schisandrae Chinensis in Shengmai Injection were responsible to the degranulation of RBL-2H3 cells. Osmotic pressures and pH influenced RBL-2H3 degranulation. High Osmotic pressure of Tanreqing Injection and low pH of chlorogenic acid at 2.5 and 5.0 mmol/L congcentration might be responsible to high β-hexosaminidase activity. Most of the TCMIs inducing degranulation had cytotoxicity effect for both RBL-2H3 and BRL cells, but some TCMIs inducing degranulation had no cytotoxicity effect. Conclusion: Some TCMIs can induce degranulation of RBL-2H3 cells;RBL-2H3 cell degranulation test can be used in non-clinical stage to detect the risk causing anaphylactoid reactions. Osmotic pressures and pH influenced RBL-2H3 degranulation, and they should be measured before testing. The mechanism of degranulation caused by some TCMIs is cytotoxic, and some are non-cytotoxic and may be through exicytosis.展开更多
Objective:To explore the law of traditional Chinese medicine in prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Methods:The literatures on prevention and treatment of gastroint...Objective:To explore the law of traditional Chinese medicine in prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Methods:The literatures on prevention and treatment of gastrointestinal reaction after chemotherapy with Chinese medicine were searched from CNKI,Wanfang and VIP databases from the establishment of the database to September 2020.After screening,the database was established,and data mining was conducted by using IBM SPSS statistics 20.0 and IBM SPSS modeler 18.0 to summarize the medication rules of traditional Chinese medicine in the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Results:(1)A total of 131 literatures involving 245 traditional Chinese medicines were included for data mining;(2)High frequency drugs include Astragalus membranaceus,liquorice,Poria cocos,Atractylodes macrocephala,Pinellia ternata,Codonopsis pilosula,Ophiopogon japonicus,coix seed,Pericarpium Citri Reticulatae,Radix Glehniae and so on;(3)The traditional Chinese medicine used is mainly tonifying deficiency medicine,resolving phlegm and relieving cough and asthma medicine,diuresis and dampness medicine,heat clearing medicine and antiphlogistic medicine.The medicine tastes bitter and sweet,and has cold and warm properties.The meridian tropism involves liver,lung,stomach,spleen and kidney;(4)Seven core TCM combinations were obtained by cluster analysis,and 24 drug pairs(groups)were obtained by association rule analysis.Conclusion:Through the data mining of traditional Chinese medicine for the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer,we can find out the potential rules of traditional Chinese medicine prescription,and clarify the core Chinese medicine,which is helpful to provide certain reference for the development and research of drugs for the treatment of gastrointestinal reaction and modern clinical practice.展开更多
Objective:To systematically access the effects of integrated traditional Chinese and western medicine treatment versus western medicine treatment alone in glioma.Methods:Published randomized controlled trials were inc...Objective:To systematically access the effects of integrated traditional Chinese and western medicine treatment versus western medicine treatment alone in glioma.Methods:Published randomized controlled trials were included from electronic databases(Cochrane Library,Pubmed,Embase,Chinese National Knowledge Infrastructure,Wanfang database,Chinese Scientific Journal Database,Chinese Biomedical Literature Database.Deadline on January 30,2020).The Cochrane handbook was referred to evaluate the methodological quality.Curative efficacy,gastrointestinal side effects,bone marrow suppression,survival time and quality of life(Karnofsky)were compared between the two groups.Meta-analysis was conducted using Reveman 5.3 and Stata 14.0 software.Results:Twelve randomized controlled trials involved 886 cases were selected,including 446 cases in the trial group and 440 cases in the control group.The meta-analysis indicated that the overall efficacy of integrated traditional Chinese and western medicine showed significant improvement compared with western medicine alone.The effects included reduced tumor size(RR=1.32,95%CI(1.18,1.49),P<0.05),gastrointestinal adverse reactions(RR=0.42,95%CI(0.30,0.60),P<0.05),bone marrow suppression(RR=0.437,95%CI(0.282,0.677),P<0.05),and improved KPS score(SMD=0.632,95%CI(0.312,0.952),P<0.05).Conclusion:For patients with glioma,integrated traditional Chinese and western medicine treatment can be one of the options for a better treatment.展开更多
Background:Parkinson’s disease is a progressive neurodegenerative disease,and is usually treated with levodopa combined with dopa decarboxylase inhibitor like Madopar.In order to improve the efficacy and reduce adver...Background:Parkinson’s disease is a progressive neurodegenerative disease,and is usually treated with levodopa combined with dopa decarboxylase inhibitor like Madopar.In order to improve the efficacy and reduce adverse reactions,Chinese herbal medicines are usually applied with Madopar to treat Parkinson’s disease in clinic.According to the results of certain randomized controlled trials,levodopa drugs combined with Chinese herbal medicines could achieve better effects like the improvement of clinical symptoms,the reduced incidence of adverse reactions,and the reduced dose of levodopa drugs(especially in the maintenance phase).However,not all the randomized controlled trials showed favorable effect on Parkinson’s disease.Therefore,it is necessary to find out how to effectively combine Chinese herbal medicines with Madopar.In order to evaluate the effects of Chinese herbal medicines on Madopar dose and adverse reaction during the maintenance phase of Parkinson’s disease,a meta-analysis was conducted.Methods:A systematic research was carried out for randomized controlled trials of combined Chinese herbal medicines and Madopar treatment for Parkinson’s disease during the maintenance phase published till August 2019.The primary outcome was the Madopar dose and secondary outcome was the incidence of adverse reaction.Data were pooled and analyzed with RevMan 5.3.Results:A total of 18 studies were included with 1,169 cases.However,study quality evaluation showed low methodological quality.Meta-analyses showed that the dose of Madopar in the treatment group was significantly lower than that in the control group,and the incidence of adverse reactions in the treatment group was also significantly lower than that in the control group.However,the correlation analysis showed that the reduction of Madopar dose was not related to the reduction of incidence of adverse reactions(P>0.05).There existed publication bias on the primary outcome and secondary outcome.Conclusions:Chinese herbal medicines could reduce the Madopar dose and adverse reaction during the maintenance phase of Parkinson’s disease treatment.This conclusion must be considered cautiously,for lack of studies of high quality.展开更多
OBJECTIVE: To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL: We retrieved publications from Cochrane Library (2004 to July 2011...OBJECTIVE: To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL: We retrieved publications from Cochrane Library (2004 to July 2011), PubMed (1966 to July 2011), the Chinese Science and Technique Journals Database (1977 to July 2011), the China National Knowledge Infrastructure (1979 to July 2011), Google Scholar (July 2011), and the Chinese Biomedical Database (1977 to July 2011) using the key words "Chinese medicine OR Chinese herbal medicine" and "vascular dementia OR mild cognition impair OR multi-infarct dementia OR small-vessel dementia OR strategic infarct dementia OR hypoperfusion dementia OR hemorrhagic dementia OR hereditary vascular dementia". SELECTION CRITERIA: Randomized controlled trials comparing Chinese herbal medicines with placebo/western medicine in the treatment of patients with vascular dementia were included. Diagnostic standards included Diagnostic and Statistical Manual of Mental Disorders-IV, and National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et I'Enseignement en Neurosciences. Two participants independently conducted literature screening, quality evaluation and data extraction. The quality of each trial was assessed according to the Cochrane Reviewers' Handbook 5.0. MAIN OUTCOME MEASURES: Effective rate, Mini-Mental State Examination scores, Hasegawa Dementia Scale scores, and incidence of adverse reactions. RESULTS: We identified 1 143 articles discussing the effects of Chinese medicine on vascular dementia. Thirty-one of these were included in the analysis. These studies involved a total of 2 868 participants (1 605 patients took Chinese medicine decoctions (treatment group); 1 263 patients took western medicine or placebo). The results of our meta-analysis revealed that Chinese herbal remedies in the treatment group were more efficacious than the control intervention (relative risk (RR) = 1.27; 95% confidence interval (C/): 1.18-1.38, P 〈 0.01). Mini-Mental State Examination scores were higher in patients taking Chinese herbal medicines than in those in the control group (weighted mean difference (WMD) = 2.83; 95%CI: 2.55-3.12, P 〈 0.01). Patients in the treatment group showed better disease amelioration than those in the control group (Hasegawa Dementia Scale scores; WMD = 2.41, 95%CI: 1.48-3.34, P 〈 0.01). There were also considerably fewer adverse reactions among those in the treatment group compared with those in the control group (RR = 0.20, 95%CI: 0.08-0.47, P 〈 0.01). CONCLUSION: Chinese herbal medicine appears to be safer and more effective than control measures in the treatment of vascular dementia. However, the included trials were generally low in quality. More well-designed, high-quality trials are needed to provide better evidence for the assessment of the efficacy and safety of Chinese medicines for vascular dementia.展开更多
目的:应用网状Meta分析方法,比较不同活血化瘀类中成药治疗糖尿病视网膜病变(DR)的临床有效率、实验室指标改善情况及治疗的安全性。方法:通过检索中国知网(CNKI)、万方数据知识服务平台、维普期刊资源整合服务平台(VIP)、Web of Scienc...目的:应用网状Meta分析方法,比较不同活血化瘀类中成药治疗糖尿病视网膜病变(DR)的临床有效率、实验室指标改善情况及治疗的安全性。方法:通过检索中国知网(CNKI)、万方数据知识服务平台、维普期刊资源整合服务平台(VIP)、Web of Science及Pubmed等数据库获得关于活血化瘀类中成药治疗DR的临床随机对照研究,检索时限为建库至2023年4月10日,并对所检索到的文献进行筛选提取资料,通过Stata 16.0软件实施网状Meta分析。结果:最终纳入63项研究,分析结果显示:复方丹参滴丸+羟苯磺酸钙胶囊总体疗效最为显著;芪明颗粒+羟苯磺酸钙胶囊在改善DR患者视力方面疗效最为显著;复方血栓通胶囊+羟苯磺酸钙胶囊在改善DR患者黄斑厚度及视野灰度值方面疗效最好;和血明目片+羟苯磺酸钙胶囊在减小患者血管瘤体积方面疗效较好;治疗组与对照组均有不良反应报道,治疗组不良反应总体较少。结论:与单用羟苯磺酸钙胶囊比较,活血化瘀类中成药联合羟苯磺酸钙胶囊治疗DR患者,可提高临床有效率,改善患者实验室检查指标,减少不良反应。展开更多
文摘Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical safe medication.Methods The cases and ADR reports of the three Chinese patent medicines and three herbal formulas in PubMed,Web of Science,Springer Link,CNKI,Wanfang and VIP database were retrieved from December 2019 to May 2021.Then we extracted and analyzed the effective information included in the literature.Results and Conclusion According to the pre-developed retrieval plan,a total of 136 documents were obtained,and a total of 6 documents met the inclusion criteria finally.553 patients used three Chinese patent medicines and three herbal formulas,and there were 133 cases of adverse reactions.The adverse reactions of patients taking the three Chinese patent medicines and three herbal formulas can all be explained under the theory of traditional Chinese medicine,and the adverse reactions can be eliminated by adding or subtracting the flavor of the medicine or stopping the medicine.
文摘Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.
基金funded by the National Natural Science Foundation of China:Surface Project(81573959)the Young Teacher Research Program of the Beijing University of Chinese Medicine(2017-JYB-JS-158)Young Scientist Program of the Dongzhimen Hospital,Beijing University of Chinese Medicine(DZMYS-201610).
文摘Immune checkpoint inhibitors(ICPI)have shown considerable promise in the treatment of tumors.However,immune-related adverse events(irAEs)caused by ICPI have been reported in nearly every organ system.Whilst this represents a new challenge in the field of cancer treatment,traditional Chinese medicine(TCM)provides benefits in the treatment of irAEs.This article reviews the studies of the treatment of immune-related gastrointestinal diseases and dermatosis with TCM and introduces the collaborative efforts between China and France in the implementation of TCM for the treatment of irAEs.
基金financially supported by the National Natural Science Foundation of China(Grant No.81803714)the Fundamental Research Funds for the Central Universities(Grant No.2019QNA7041).
文摘Chromatographic fingerprinting has been perceived as an essential tool for assessing quality and chemical equivalence of traditional Chinese medicine.However,this pattern-oriented approach still has some weak points in terms of chemical coverage and robustness.In this work,we proposed a multiple reaction monitoring(MRM)-based fingerprinting method in which approximately 100 constituents were simultaneously detected for quality assessment.The derivative MRM approach was employed to rapidly design MRM transitions independent of chemical standards,based on which the large-scale fingerprinting method was efficiently established.This approach was exemplified on QiShenYiQi Pill(QSYQ),a traditional Chinese medicine-derived drug product,and its robustness was systematically evaluated by four indices:clustering analysis by principal component analysis,similarity analysis by the congruence coefficient,the number of separated peaks,and the peak area proportion of separated peaks.Compared with conventional ultraviolet-based fingerprints,the MRM fingerprints provided not only better discriminatory capacity for the tested normal/abnormal QSYQ samples,but also higher robustness under different chromatographic conditions(i.e.,flow rate,apparent pH,column temperature,and column).The result also showed for such large-scale fingerprints including a large number of peaks,the angle cosine measure after min-max normalization was more suitable for setting a decision criterion than the unnormalized algorithm.This proof-of-concept application gives evidence that combining MRM technique with proper similarity analysis metrices can provide a highly sensitive,robust and comprehensive analytical approach for quality assessment of traditional Chinese medicine.
文摘Aims: To study RBL-2H3 cell degranulation phenomena induced by some TCMIs through cell morphological and ultra-structural observation, released enzyme activity and establish RBL-2H3 cell degranulation test indicated by β- hexosaminidase activity as a method to evaluate TCMIs at nonclinical stage. Methods: RBL-2H3 cells were used to study the degranulation by co-culture with positive control C48/80 and some TCMIs through morphological and ultra-structure observation, β-hexosaminidase activity detection. RBL-2H3 cell degranulation test was established to detect β-hexosaminidase activity caused by 17 kinds of TCMIs and their ingredients. The cytotoxicity effect of some TCMIs on both RBL 2H3 and BRL cells was measured by CCK-8 assay. Results: Toluidine blue staining and ultra-structure of electronic microscope observation of treated RBL-2H3 cells showed degranulation morphologically. Detection of β-hexosaminidase activity in the supernatant of treated cells showed some TCMIs had elevated enzyme release rates. Further analysis of the ingredients and compound in Tanreqing Injection and Shengmai Injection showed Scutellaria baicalensis Georgi in Tanreqing Injection, Red ginseng and Fructus Schisandrae Chinensis in Shengmai Injection were responsible to the degranulation of RBL-2H3 cells. Osmotic pressures and pH influenced RBL-2H3 degranulation. High Osmotic pressure of Tanreqing Injection and low pH of chlorogenic acid at 2.5 and 5.0 mmol/L congcentration might be responsible to high β-hexosaminidase activity. Most of the TCMIs inducing degranulation had cytotoxicity effect for both RBL-2H3 and BRL cells, but some TCMIs inducing degranulation had no cytotoxicity effect. Conclusion: Some TCMIs can induce degranulation of RBL-2H3 cells;RBL-2H3 cell degranulation test can be used in non-clinical stage to detect the risk causing anaphylactoid reactions. Osmotic pressures and pH influenced RBL-2H3 degranulation, and they should be measured before testing. The mechanism of degranulation caused by some TCMIs is cytotoxic, and some are non-cytotoxic and may be through exicytosis.
基金National Natural Science Foundation of China(No.81673797)。
文摘Objective:To explore the law of traditional Chinese medicine in prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Methods:The literatures on prevention and treatment of gastrointestinal reaction after chemotherapy with Chinese medicine were searched from CNKI,Wanfang and VIP databases from the establishment of the database to September 2020.After screening,the database was established,and data mining was conducted by using IBM SPSS statistics 20.0 and IBM SPSS modeler 18.0 to summarize the medication rules of traditional Chinese medicine in the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Results:(1)A total of 131 literatures involving 245 traditional Chinese medicines were included for data mining;(2)High frequency drugs include Astragalus membranaceus,liquorice,Poria cocos,Atractylodes macrocephala,Pinellia ternata,Codonopsis pilosula,Ophiopogon japonicus,coix seed,Pericarpium Citri Reticulatae,Radix Glehniae and so on;(3)The traditional Chinese medicine used is mainly tonifying deficiency medicine,resolving phlegm and relieving cough and asthma medicine,diuresis and dampness medicine,heat clearing medicine and antiphlogistic medicine.The medicine tastes bitter and sweet,and has cold and warm properties.The meridian tropism involves liver,lung,stomach,spleen and kidney;(4)Seven core TCM combinations were obtained by cluster analysis,and 24 drug pairs(groups)were obtained by association rule analysis.Conclusion:Through the data mining of traditional Chinese medicine for the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer,we can find out the potential rules of traditional Chinese medicine prescription,and clarify the core Chinese medicine,which is helpful to provide certain reference for the development and research of drugs for the treatment of gastrointestinal reaction and modern clinical practice.
基金National Natural Science Foundation of China(NO.81601754)Key Research and Development project of Shandong Province(2018GSF118141)。
文摘Objective:To systematically access the effects of integrated traditional Chinese and western medicine treatment versus western medicine treatment alone in glioma.Methods:Published randomized controlled trials were included from electronic databases(Cochrane Library,Pubmed,Embase,Chinese National Knowledge Infrastructure,Wanfang database,Chinese Scientific Journal Database,Chinese Biomedical Literature Database.Deadline on January 30,2020).The Cochrane handbook was referred to evaluate the methodological quality.Curative efficacy,gastrointestinal side effects,bone marrow suppression,survival time and quality of life(Karnofsky)were compared between the two groups.Meta-analysis was conducted using Reveman 5.3 and Stata 14.0 software.Results:Twelve randomized controlled trials involved 886 cases were selected,including 446 cases in the trial group and 440 cases in the control group.The meta-analysis indicated that the overall efficacy of integrated traditional Chinese and western medicine showed significant improvement compared with western medicine alone.The effects included reduced tumor size(RR=1.32,95%CI(1.18,1.49),P<0.05),gastrointestinal adverse reactions(RR=0.42,95%CI(0.30,0.60),P<0.05),bone marrow suppression(RR=0.437,95%CI(0.282,0.677),P<0.05),and improved KPS score(SMD=0.632,95%CI(0.312,0.952),P<0.05).Conclusion:For patients with glioma,integrated traditional Chinese and western medicine treatment can be one of the options for a better treatment.
基金supported by Guangdong Basic and Applied Basic Research Foundation(2019A1515010644)Major Research and Development Program of Shandong Province,China(2018GSF118149)Project of Traditional Chinese Medicine Bureau of Guangdong Province(No.20201073).
文摘Background:Parkinson’s disease is a progressive neurodegenerative disease,and is usually treated with levodopa combined with dopa decarboxylase inhibitor like Madopar.In order to improve the efficacy and reduce adverse reactions,Chinese herbal medicines are usually applied with Madopar to treat Parkinson’s disease in clinic.According to the results of certain randomized controlled trials,levodopa drugs combined with Chinese herbal medicines could achieve better effects like the improvement of clinical symptoms,the reduced incidence of adverse reactions,and the reduced dose of levodopa drugs(especially in the maintenance phase).However,not all the randomized controlled trials showed favorable effect on Parkinson’s disease.Therefore,it is necessary to find out how to effectively combine Chinese herbal medicines with Madopar.In order to evaluate the effects of Chinese herbal medicines on Madopar dose and adverse reaction during the maintenance phase of Parkinson’s disease,a meta-analysis was conducted.Methods:A systematic research was carried out for randomized controlled trials of combined Chinese herbal medicines and Madopar treatment for Parkinson’s disease during the maintenance phase published till August 2019.The primary outcome was the Madopar dose and secondary outcome was the incidence of adverse reaction.Data were pooled and analyzed with RevMan 5.3.Results:A total of 18 studies were included with 1,169 cases.However,study quality evaluation showed low methodological quality.Meta-analyses showed that the dose of Madopar in the treatment group was significantly lower than that in the control group,and the incidence of adverse reactions in the treatment group was also significantly lower than that in the control group.However,the correlation analysis showed that the reduction of Madopar dose was not related to the reduction of incidence of adverse reactions(P>0.05).There existed publication bias on the primary outcome and secondary outcome.Conclusions:Chinese herbal medicines could reduce the Madopar dose and adverse reaction during the maintenance phase of Parkinson’s disease treatment.This conclusion must be considered cautiously,for lack of studies of high quality.
基金supported by a Special Funding Project for the Chinese National Outstanding Ph.D.Thesis Author,No.201082the First Grade of China Postdoctoral Science Foundation,No.20110490080the National Natural Science Foundation of China,No.81202653
文摘OBJECTIVE: To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL: We retrieved publications from Cochrane Library (2004 to July 2011), PubMed (1966 to July 2011), the Chinese Science and Technique Journals Database (1977 to July 2011), the China National Knowledge Infrastructure (1979 to July 2011), Google Scholar (July 2011), and the Chinese Biomedical Database (1977 to July 2011) using the key words "Chinese medicine OR Chinese herbal medicine" and "vascular dementia OR mild cognition impair OR multi-infarct dementia OR small-vessel dementia OR strategic infarct dementia OR hypoperfusion dementia OR hemorrhagic dementia OR hereditary vascular dementia". SELECTION CRITERIA: Randomized controlled trials comparing Chinese herbal medicines with placebo/western medicine in the treatment of patients with vascular dementia were included. Diagnostic standards included Diagnostic and Statistical Manual of Mental Disorders-IV, and National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et I'Enseignement en Neurosciences. Two participants independently conducted literature screening, quality evaluation and data extraction. The quality of each trial was assessed according to the Cochrane Reviewers' Handbook 5.0. MAIN OUTCOME MEASURES: Effective rate, Mini-Mental State Examination scores, Hasegawa Dementia Scale scores, and incidence of adverse reactions. RESULTS: We identified 1 143 articles discussing the effects of Chinese medicine on vascular dementia. Thirty-one of these were included in the analysis. These studies involved a total of 2 868 participants (1 605 patients took Chinese medicine decoctions (treatment group); 1 263 patients took western medicine or placebo). The results of our meta-analysis revealed that Chinese herbal remedies in the treatment group were more efficacious than the control intervention (relative risk (RR) = 1.27; 95% confidence interval (C/): 1.18-1.38, P 〈 0.01). Mini-Mental State Examination scores were higher in patients taking Chinese herbal medicines than in those in the control group (weighted mean difference (WMD) = 2.83; 95%CI: 2.55-3.12, P 〈 0.01). Patients in the treatment group showed better disease amelioration than those in the control group (Hasegawa Dementia Scale scores; WMD = 2.41, 95%CI: 1.48-3.34, P 〈 0.01). There were also considerably fewer adverse reactions among those in the treatment group compared with those in the control group (RR = 0.20, 95%CI: 0.08-0.47, P 〈 0.01). CONCLUSION: Chinese herbal medicine appears to be safer and more effective than control measures in the treatment of vascular dementia. However, the included trials were generally low in quality. More well-designed, high-quality trials are needed to provide better evidence for the assessment of the efficacy and safety of Chinese medicines for vascular dementia.
文摘目的:应用网状Meta分析方法,比较不同活血化瘀类中成药治疗糖尿病视网膜病变(DR)的临床有效率、实验室指标改善情况及治疗的安全性。方法:通过检索中国知网(CNKI)、万方数据知识服务平台、维普期刊资源整合服务平台(VIP)、Web of Science及Pubmed等数据库获得关于活血化瘀类中成药治疗DR的临床随机对照研究,检索时限为建库至2023年4月10日,并对所检索到的文献进行筛选提取资料,通过Stata 16.0软件实施网状Meta分析。结果:最终纳入63项研究,分析结果显示:复方丹参滴丸+羟苯磺酸钙胶囊总体疗效最为显著;芪明颗粒+羟苯磺酸钙胶囊在改善DR患者视力方面疗效最为显著;复方血栓通胶囊+羟苯磺酸钙胶囊在改善DR患者黄斑厚度及视野灰度值方面疗效最好;和血明目片+羟苯磺酸钙胶囊在减小患者血管瘤体积方面疗效较好;治疗组与对照组均有不良反应报道,治疗组不良反应总体较少。结论:与单用羟苯磺酸钙胶囊比较,活血化瘀类中成药联合羟苯磺酸钙胶囊治疗DR患者,可提高临床有效率,改善患者实验室检查指标,减少不良反应。
文摘动脉粥样硬化(atherosclerosis, AS)是脂质沉积于血管壁导致的慢性炎症性疾病,是冠心病、高血压病、心力衰竭等心脑血管疾病的病理基础,动脉粥样硬化斑块的稳定或破裂是心血管事件发生与否的重要影响因素。细胞焦亡是一种促炎性质的程序性细胞死亡,过度的细胞焦亡可引起细胞裂解死亡并发级联炎症反应。越来越多的研究表明细胞焦亡在AS的病理进程中扮演重要角色,NOD样受体蛋白3 (nod-like receptor protein 3,NLRP3)、半胱氨酸天冬氨酸蛋白酶-1(cysteinyl aspartate specific proteinase-1,Caspase-1)、细胞焦亡执行蛋白(gasdermin D,GSDMD)等细胞焦亡的关键蛋白参与AS血管内皮细胞损伤、内皮功能障碍、平滑肌细胞表型转换、巨噬细胞死亡、泡沫细胞形成等过程,已成为AS新的治疗靶点。中医药是历史悠久的医药学体系,随着研究的深入,中药复方及中药单体活性成分通过调控细胞焦亡干预AS的作用逐步被阐明,且具有多途径,多靶点,不良反应小等独特优势。基于上述研究,阐述细胞焦亡的概念及发生机制,归纳细胞焦亡在AS病程中的作用,并总结中药复方和单味中药有效成分基于细胞焦亡干预AS的研究进展,以期为AS的防治及中药新药的开发提供新的思路。