The potential of Chinese herbal medicines in treating anxiety disorders

In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.

Bioactive Components of Chinese Herbal Medicines in the Treatment of Glucose and Lipid Metabolism Disorders:Evidence and Potential Mechanisms

Disturbed cholesterol and glucose homeostasis play crucial roles in the development of various diseases such as cardiovascular diseases,cerebrovascular diseases,central nervous system diseases,and cancer.An increasing number of studies have shown that excessive body fat accumulation is associated with type 2 diabetes or insulin resistance in a vicious cycle.This vicious cycle promotes the occurrence and development of the aforementioned diseases.Therefore,stabilizing the blood lipids and blood glucose of patients is the predominant strategy for improving the symptoms of patients with cardiovascular,cerebrovascular,and central nervous system diseases.Traditional Chinese medicine,mainly Chinese herbal medicine(CHM),has a history of more than 2000 years in China,which has established a unique theory and accumulated a great wealth of clinical experience.Moreover,CHM has been widely used in China and other countries for the treatment of cardiovascular and cerebrovascular diseases,with the advantages of preventing and curing hyperlipidemia,diabetes,hypertension,and other diseases.However,the use of CHM in Western countries remains rather limited,partly because of the incomplete understanding of multiple complex components and uncertain pharmacological mechanisms.Herein,we review and discuss the benefits,molecular mechanisms,and clinical research progress of bioactive components of CHM and their preparations as therapeutics for hyperlipidemia and hyperglycemia.

Comparing the effectiveness of pattern differentiation treatment and fixed formula treatment for perimenopausal syndrome with Chinese herbal medicine:A study protocol

Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.

Reduced risk of dementia in patients with type 2 diabetes mellitus using Chinese herbal medicine:A nested case-control study

BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)patients.While Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully elucidated.AIM To compare the risk of dementia between T2DM patients with and without CHM treatment.METHODS We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in Taiwan.Cases,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 ratio.We applied conditional logistic regression to explore the associations between CHM treatment and dementia.RESULTS A total of 11699 dementia cases were matched to 11699 non-dementia controls.We found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of 0.22.CONCLUSION This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.

Systematic review and meta-analysis of endometrial thickening during endocrine therapy combined with Chinese herbal medicine intervention after breast cancer surgery

Objective:To systematically evaluate the endometrial thickening and Chinese herbal medicine intervention effects during endocrine therapy following breast cancer surgery.Methods:Computerized searches were performed on CNKI,CBM,Wanfang,VIP,Pub Med,Embase,and Cochrane to gather randomized controlled trials(RCTs)of endometrial thickening combined with Chinese herbal medicine intervention during endocrine therapy after breast cancer surgery.The meta analysis is done using Rev Man 5.4,and the retrieval range is from the database's creation to January 2023.Results:There were 710 patients enrolled in a total of 12 RCTs.The results of Meta-analysis were as follows:combined with Chinese herbal medicine treatment for 3 months of endometrial thickness(MD=-1.12,95%CI[-1.47,0.77],P<0.00001);6 months endometrial thickness(MD=-1.90,95%CI[-2.38,-1.42],P<0.00001);endometrial thickness at 12 months(MD=-2.24,95%CI[-2.96,-1.52],P<0.00001);modified Kupperman score(MD=-10.45,95%CI[-19.10,-1.80],P=0.02);TCM syndrome score(SMD=-1.53,95%CI[-1.84,-1.22],P<0.00001);KPS score(MD=3.75,95%CI[2.81,4.68],P<0.00001);there was no significant difference in CA153,CEA,FSH and E2 between the two groups.Conclusion:After breast cancer surgery,endocrine therapy combined with Chinese herbal medicine can significantly lessen endometrial thickening and enhance patient quality of life.

Discovering the efficacy and mechanism of Chinese herbal medicine for distal symmetric polyneuropathy via integrating meta-analysis and network pharmacology analysis

Objective Chinese herbal medicine(CHM)has been commonly used in Distal Symmetric Polyneuropathy(DSPN)treatment with satisfactory clinical effects,but the underlying pharmacological mechanism of CHM on DSPN remains unclear.We aimed to identify frequently used clinically effective CHM and its potential pharmacological mechanisms for DSPN by conducting meta-analysis and network pharmacology analysis.Methods We searched both Chinese and English databases from March 1990 to October 2022.Studies that met the inclusion criteria were selected for meta-analysis.After extracting the relevant data,we performed meta-analysis and frequency analysis.The active compounds and predicted targets of high-frequency herbs and DSPN-related targets were extracted from public databases.Then we conducted network construction,Gene Ontology(GO)enrichment,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis to discover the potential pharmacological mechanisms.Results Sixteen articles were selected for meta-analysis,and nine high-frequency CHMs were identified,including Radix Astragali seu Hedysari,Rhizoma Ligustici,Caulis Spatholobi,Radix Salviae Miltiorrhizae,Radix Paeoniae Alba,Flos Carthami,Radix Notoginseng,Radix Rehmanniae Recens,Rhizoma Corydalis.Fourteen hub targets including STAT3,CTNNB1,MAPK14,SRC,AKT1,TP53,EGFR,JUN,RELA,MAPK1,FOS,CCND1,HSP90AA1,MYC,and ten active compounds including Quercetin,Kaempferol,Luteolin,Apigenin,beta-sitosterol,Stigmasterol,Caffeic Acid,Aeginetic Acid,Vanillin,and Lauric Acid were identified by network analysis.Enrichment analysis showed that the biological process of hub targets included transcriptional regulation,cell proliferation,redox processes,apoptosis processes,ERK1 and ERK2 cascades,hypoxia reactions,MAPK cascades,and inflammatory responses.The main signalling pathways included HIF,TNF,and PI3K-AKT pathways.Conclusion Nine herbs were involved in the clinical therapeutic effect of CHM on DSPN treatment,and they may exert an anti-DSPN effect by regulating cell proliferation,apoptosis,and redox processes.

Integration of Chinese herbal medicines and exercise for insomnia:a systematic review and meta-analysis

Background:As a disease,insomnia is often ignored by the general public.Insomnia,which not directly fatal,may be equivalent to chronic suicide if it is not paid attention to.However,there are many theories on how to treat insomnia,and researchers have been searching for a cure.Chinese herbal medicine(CHM)and exercise therapy(ET)are relatively effective,and have been used since ancient times to treat insomnia.This study aimed to examine the effect of CHM combined with ET(CHM-ET)on patients with insomnia.Methods:We searched eight electronic databases including PubMed,Web of Science,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure(CNKI),the China Biology Medicine disc(CBMdisc),the China Science and Technology Journal Database(VIP),the Wanfang Database to find randomized controlled trials(RCTs)evaluating CHM-ET in the treatment of insomnia patients up to September 13,2022.Two researchers read and screened the publications to extract data.We used the pittsburgh sleep quality index(PSQI)as the evaluation indicators for each study,and the other was the total effective rate(TER).The Cochrane risk-of-bias assessment tool was used to assess the risk of bias of the included literature.The level of evidence for this result was assessed by GARDE method.The meta-analysis was performed using STATA 14 software and RevMan 5.3.The research method was registered with PROSPERO(CRD42022350926).Results:We included fourteen randomized controlled trials,which including a total of 1,126 participants.Compared with the control group,the experimental group showed significantly improvements in sleep effect as reflected by the reduced PSQI score[mean difference(MD)=-2.47,95%confidence interval(CI)(-3.15,-1.78),I^(2)=92%]with low quality of evidence,and increased TER[risk ratio(RR)=1.23,95%CI(1.14,1.33),I^(2)=40%]with moderate quality of evidence.Compared with hypnotic drugs,CHM-ET significantly reduced the PSQI score[mean difference(MD)=-3.18,95%CI(-5.48,-0.89),I^(2)=73%]with low quality of evidence.The PSQI of CHM-ET significantly decreased compared with single CHM[mean difference(MD)=-3.04,95%CI(-5.84,-0.25),I^(2)=98%]with low quality of evidence,and ET[mean difference(MD)=-2.44,95%CI(-2.87,-2.02),I^(2)=0%]with moderate quality of evidence.No serious adverse reactions were observed.Conclusion:This review suggested that CHM-ET may be an effective treatment for insomnia.However,given the limited quality of the studies and methodologies included in the trials,further rigorous randomized controlled trials are needed for more accurate results.

Screening test for anti-Helicobacter pylori activity of traditional Chinese herbal medicines

AIM:To evaluate the anti-Helicobacter pylori (H.pylori) activity of 50 traditional Chinese herbal medicines in order to provide the primary evidence for their use in clinical practice.METHODS:A susceptibility test of water extract from 50 selected traditional Chinese herbal medicines for in vitro H.pylori Sydney strain 1 was performed with broth dilution method.Anti-H.pylori activity of the selected Chinese herbal medicines was evaluated according to their minimum inhibitory concentration (MIC).RESULTS:The water extract from Rhizoma Coptidis,Radix Scutellariae and Radix isatidis could significantly inhibit the H.pylori activity with their MIC less than 7.8 mg/mL,suggesting that traditional Chinese herbal medicines have anti-inflammatory and antibacterial effects and can thus be used in treatment of H.pylori infection.CONCLUSION:Rhizoma Coptidis,Radix Scutellariae and Radix isatidis are the potential sources for the synthesis of new drugs against H.pylori.

Outcome of the efficacy of Chinese herbal medicine for functional constipation:A systematic review and meta-analysis

BACKGROUND Functional constipation(FC)is a common and chronic gastrointestinal disease and its treatment remains challenging.AIM To evaluate the efficacy and safety of Chinese herbal medicine(CHM)on efficacy rate,global symptoms,bowel movements and the Bristol Stool Scale score in patients with FC by summarizing current available randomized controlled trials(RCTs).METHODS RCTs with CHM to treat FC were identified by a systematic search of six databases from inception to October 20,2020.Two independent reviewers assessed the quality of the included articles and extracted data.Meta-analyses were performed to odds ratio(OR),mean differences(MD)and 95%confidence interval(CI)using random-effects models.Subgroup analyses and sensitivity analyses were used to explore and interpret the sources of heterogeneity.The funnel plot,Begg’s test and Egger’s test were used to detect publication bias.RESULTS Ninety-seven studies involving 8693 patients were included in this work.CHM was significantly associated with a higher efficacy rate(OR:3.62,95%CI:3.19-4.11,P<0.00001)less severe global symptoms(OR:4.03,95%CI:3.49-4.65,P<0.00001)compared with control treatment,with the low heterogeneity between studies(I2=0%,P=0.76).CHM was also associated with more frequent bowel movements(MD 0.83,95%CI:0.67-0.98,P<0.00001),a lower score on the Bristol Stool Scale(OR:1.63,95%CI:1.15-2.32,P<0.006),and a not significant recurrence rate(OR:0.47,95%CI:0.22-0.99,P=0.05).No serious adverse effects of CHM were reported.CONCLUSION In this meta-analysis,we found that CHM may have potential benefits in increasing the number of bowel movements,improving stool characteristics and alleviating global symptoms in FC patients.However,a firm conclusion could not be reached because of the poor quality of the included trials.Further trials with higher quality are required.

Effects of Nano Chinese Herbal Medicine Feed Additive on Growth Performance,Meat Quality and Disease Resistance of Chickens

[Objectives]To explore the effects of nano compound Chinese herbal medicine feed additive on growth performance,meat quality and disease resistance of chickens.[Methods]Chickens were fed with nano compound Chinese herbal medicine feed additive developed by Hunan Polytechnic of Environment and Biology,including 120 chickens in the treatment group and 120 chickens in the control group(CK).The growth performance indices(body weight gain,feed to gain ratio and slaughter index),meat quality indices(pH value,color,drip loss,shear force)and disease resistance indices(morbidity and mortality)of the chickens in the treatment and CK groups were recorded and determined,respectively.[Results]The inclusion of 2%nano compound Chinese herbal medicine feed additive in the diet significantly increased the growth rate,reduced the feed-to-gain ratio and improved the meat quality of the chickens.Supplementing Chinese herbal medicine could increase the pH value and reduce the drip loss and shear force of chicken meat.At the same time,the body's immune function,antioxidant level and resistance against diseases of the chickens fed with nano compound Chinese herbal medicine feed additive were improved.[Conclusions]The inclusion of nano compound Chinese herbal medicine feed additive in the diet can improve the growth performance,meat quality and disease resistance of chickens.

Efficacy of Chinese herbal medicine in functional dyspepsia: A meta-analysis of randomized, double-blind, placebo-controlled trials

Objective:To evaluate the efficacy and safety of Chinese herbal medicine(CHM)for the treatment of functional dyspepsia(FD).Methods:Web of Science,PubMed,EMBASE,Cochrane Library,and four other Chinese electronic databases,including China National Knowledge Infrastructure(CNKI),Chinese Biological Medical Database(CBM),Chinese Scientific Journals Database(VIP),and WanFang Database were used to search(up to Feb,2016)for randomized,double-blind,placebocontrolled trials recruiting adults with FD treated with CHM.Study selection,data extraction,quality assessment,and data analyses were conducted based on Cochrane standards using Review Manager software.Results:Fourteen publications(1424 patients)were included.Evidence revealed that CHM was more efficacious than the placebo in improving global dyspepsia symptoms(RR,1.45;95%CI,1.31e1.60),Chinese medicine syndrome(CMS)(RR,1.36;95%CI,1.23e1.50),and quality of life(SMD,0.30;95%CI,0.15e0.45)in FD patients.Furthermore,the difference in the incidence of adverse events between CHM and placebo groups had no statistical significance(RR,1.06;95%CI,0.66e1.70).Conclusion:This meta-analysis demonstrates that CHM has a therapeutic potential in treating FD with a certain safety.However,due to the restricted number of trials included,wellplanned,long-term studies are necessary to provide credible evidence.

Protection and Quality Control of Wild Chinese Herbal Medicine Resources in Nature Reserves by Taking Longyuwan Scenic Spot Within Funiu Mountain Nature Reserve as an Example

This paper discussed how to protect and control the quality of wild Chinese herbal medicine resources in nature reserves by taking Longyuwan National Forest Park within Funiu Mountain Nature Reserve as an example.Through the combination of three methods including literature review,visiting and investigational studies,and field surveys,the data of investigation,collection and collation were analyzed.According to data of surveys,collection and collation,problems related to the protection of wild Chinese herbal medicine resources faced by Longyuwan Scenic Spot within Funiu Mountain Nature Reserve were also analyzed and protection strategies and quality control of wild Chinese herbal medicine resources in this nature reserve were discussed.It was expected that the results would provide important scientific references for the sustainable development,protection and quality control of wild Chinese herbal medicine resources within nature reserves.

Chinese herbal medicine for incomplete immune reconstruction in patients with AIDS undergoing antiretroviral treatment: A systematic review of randomized trials

Objective:To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs)for incomplete immune reconstruction in patients with HIV/AIDS.Methods:Eight electronic databases were searched for randomized controlled trials(RCTs)on the use of CHM for patients with HIV/AIDS with incomplete immune reconstruction.Outcomes included CD4þcell count,quality of life,and adverse events/effects.The Cochrane Risk of Bias was employed to evaluate the methodological quality of the included RCTs.Results:We identified 13 eligible RCTs,with an overall high risk of bias,on 10 different CHMs.There was a significant increase in CD4þcell count after the use of Jianpi Yiqi medicinal paste for 3 months;tripterygium glycosides tablets(TGTs)for 3 months(mean difference[MD]52.63 cells/mL,95%confidence interval[CI,46.98,58.28]),6,9,and 12 months;Wenshen Jianpi granules for 6 months;Shenling Fuzheng capsules for 6 months(MD 49.53 cells/mL,95%CI[8.45,90.61])and 12 months;Aikeqing granules for 9 months(MD 61.51 cells/mL,95%CI[16.25,106.77])and 12 months;Guipi decoction for 12 months;Mianyi No.2 granules(JT)for 12 and 18 months;and Chinese medicine granules for 18 months.The increase in the mean difference of CD4þcell count from 6 to 18 months was larger in Chinese medicine granules and Mianyi No.2 granules(JT).Guipi decoction and Jianpi Qushi decoction improved the Karnofsky score.Four RCTs reported the outcome of adverse events/effects,while four cases of minor adverse effects were reported in the TGTs group.Conclusion:Jianpi Yiqi medicinal paste,Wenshen Jianpi granules,Shenling Fuzheng capsules,Aikeqing granules,Guipi decoction,and TGTs may be effective in increasing CD4þwithin 12 months,and Mianyi No.2 granules(JT)and Chinese medicine granules may show long-term effects.High-quality large RCTs on the effectiveness and safety of CHMs are still warranted.

Drug discovery from traditional Chinese herbal medicine using high content imaging technology

Traditional Chinese medicine(TCM) has been widely used in China and other Asia countries for thousands of years to treat or prevent human diseases. Chinese herbal medicine, one of the most important components of TCM, has unique diversities in chemical components, and thus results in a wide range of biological activities. However, pharmaceutical industry is facing a major challenge to develop a large population of novel natural products and drugs, and considerable efforts have not resulted in highvolume of novel drug discovery and productivity. At present, increasing attention has been paid to Chinese herb medicine modernization in combination with the cutting-age technologies of drug discovery, especially the high throughput selection. High content imaging is an image-based high throughput screening method by using automated microscopy and image analysis software to capture and analyze phenotypes at a large scale to investigate multiple biological features simultaneously in the biological complex. Here, we described the pipeline of the state-of-the-art high content imaging technology, summarized the applications of the high content imaging technology in drug discovery from traditional Chinese herbal medicine, and finally discussed the current challenges and future perspectives for development of high throughput image-based screening technology in novel drug research and discovery.

Effects of Chinese Herbal Medicine Additives on Growth,Immunity and Antioxidation of Chickens

Chinese herbal medicine additives can not only directly improve the growth performance of chickens,but also indirectly affect the growth of chickens by enhancing the antioxidant capacity,immunity and disease resistance of the body,and eliminating diseases and adverse factors,thereby improving the growth performance of chickens.In the context of the current national prohibition of adding antibiotics to feed,the research and application of Chinese herbal medicine additives are of practical significance to eliminate the long-term use of antibiotics as chicken feed additives and reduce the threat to the environment and human health.For this reason,the research related to the substitution of Chinese herbal medicine for antibiotics is made a brief introduction to provide a reference in research and production practice.

Effects of Diet with "Lianteng" Additive of Chinese Herbal Medicine on Blood Biochemical Indexes,Immune and Antioxidant Function of Guangxi Sanhuang Chickens

[Objectives]This trial was conducted to investigate the effects of diet with"Lianteng"additive of Chinese herbal medicine on blood biochemical indexes,immune and antioxidant function of Guangxi Sanhuang chickens.[Methods]480 Guangxi Sanhuang chickens at the age of 1 d were divided into 4 groups randomly and each group was assigned to 6 replicates with 20 chicks in each replicate;groups A,B and C were treatment groups and fed basal diets with 0.1%,0.2%and 0.4%of"Lianteng"additive of Chinese herbal medicine respectively during a trial of 70 d.Group D was control group and fed only basal diet.The serum samples were taken from 6 chicks in each group at the age of 21,35 and 49 d respectively and analyzed for biochemical,immune and antioxidant parameters in serum.[Results]Results from the trial showed that no difference was found in serum content of GLU,TG,TP,TC,and UN in the measurement at the age of 21,35 and 49 d(P>0.05);however,the content of ALB from groups A and B at 35 d was significantly higher than that from group D(P<0.01),and the ALB content from group B at 49 d was also higher than that from group D(P<0.05);the IgM content at 49 d from group A was lower than that from group D(P<0.05),in addition to this,there was no differences found in the contents of IgG,IgM and IFN-y among groups A,B,C and D during the trial(P>0.05);but the content of IL-2 from groups A and B at 49 d was significantly greater than that from group D(P<0.05);T-AOC from groups A,B and C at 49 d was very significantly higher than that from group D(P<0.01),and the one of group B at 35 d was still obviously higher than that of group D(P<0.05);also at 49 d,the GSH content in groups A and B was much greater than that in group D(P<0.01);T-SOD activity of group B and C at 35 d was distinctly greater than that of group D(P<0.05).[Conclusions]It can be concluded that the addition of 0.2%of"Lianteng"additive of Chinese herbal medicine in diet can increase immune function in a certain extent and promote the antioxidant ability observably for Guangxi Sanhuang chickens.

Wavelet-based classification and influence matrix analysis method for the fast discrimination of Chinese herbal medicines according to the geographical origins with near infrared spectroscopy

A discriminant analysis technique using wavelet transformation(WT)and influence matrixanalysis(CAIMAN)method is proposed for the near infrared(NIR)spectroscopy classifi-cation.In the proposed methodology,NIR spectra are decomposed by WT for data com-pression and a forward feature selection is further employed to extract the relevant informationfrom the wavelet coefficients,reducing both classification errors and model complexity.Adiscriminant-CAIMAN(D-CAIMAN)method is utilized to build the classification model inwavelet domain on the basis of reduced wavelet coefficients of spectral variables.NIR spectradata set of 265 salviae miltiorrhizae radia samples from 9 different geographical origins is usedas an example to test the classification performance of the algorithm.For a comparison,k-nearest neighbor(KNN),linear discriminant analysis(LDA)and quadratic discriminant analysis(QDA)methods are also employed.D-CAIMAN with wavelet-based feature selection(WD-CAIMAN)method shows the best performance,achieving the total classification rate of ioo%in both cross-validation set and prediction set.It is worth noting that the WD-CAIMANclassifier also shows improved sensitivity,selectivity and model interpretability in thecla.ssifications.

Efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs against recurrent genital herpes:a systematic review and meta-analysis

Background:To compare the efficacy and safety of Chinese herbal medicine combined with nucleoside antiviral drugs and nucleoside antiviral drugs alone in treating recurrent genital herpes.Methods:PubMed,Embase,Web of Science,Cochrane Library,Chinese Biomedical Literature Database,China National Knowledge Internet,VIP Database,and Wanfang Data were searched from inception to April 2021.Randomized controlled trials on the efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs for recurrent genital herpes were collected.All included trials were independently assessed by two reviewers with the Cochrane risk-of-bias tool,and a meta-analysis was conducted using Review Manager 5.4.Results:Compared with the use of nucleoside antiviral drugs alone,combination therapy with oral Chinese herbal medicine plus nucleoside antiviral drugs effectively reduced the herpes recurrence rate after the end of treatment(3 months:P=0.0002;6 months:P<0.00001;1 year:P<0.00001)and the number of recurrences each year(P<0.00001),improved the recurrent Genital Herpes Quality of Life Questionnaire score(P<0.00001),and regulated the levels of interferon-γ,interleukin-2,tumor necrosis factor-α,and T lymphocyte subsets in the peripheral blood,and the difference was statistically significant.Different subgroups reported mixed results with respect to the efficacy in the short term.The incidence of adverse reactions and the time of symptom disappearance between the two groups were not significantly different.Conclusion:Chinese herbal medicine combined with nucleoside antiviral drugs can effectively reduce the recurrence rate of recurrent genital herpes,improve the patient’s quality of life and enhance the body’s immunity.Considering the possible risk of publication bias,more high-quality randomized controlled trials are still needed to verify the conclusions of this article.

Effectiveness and safety of acupoint catgut embedding combined with Chinese herbal medicine in chronic urticaria: A systematic review of randomized controlled trials

Objective:To evaluate the effectiveness and safety of acupoint catgut embedding(ACE)in combination with Chinese herbal medicine(CHM)in treating chronic urticaria(CU).Methods:We thoroughly searched Embase,PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wangfang database,Chinese Scientific Journal Database(VIP),and Chinese biomedical literature database(SinoMed)for relevant studies from inception until May 2022.Randomized controlled trials(RCTs)on ACE combined with CHM for CU were included.Literature search,data extraction,and risk of bias assessment were independently conducted by two authors.Results:A total of 15 RCTs with 1065 participants were included in this review.Five trials reported that the combined therapy showed a higher total effective rate,and four trials reported that the combined therapy was associated with a lower level of serum immunoglobulin E.Furthermore,two,four,and four trials reported that the combined therapy was more effective in reducing itching degree,size,and number of wheals,respectively.The combined therapy was reported to be associated with a lower recurrence rate in three trials,and with a fewer adverse reaction rate in two trials.Conclusions:ACE in combination with CHM appears to be a safe and effective therapy for patients with CU.Given the relatively low quality of the included trials,these findings should be interpreted cautiously.Further high-quality RCTs are needed to confirm our findings.

Adding Chinese herbal medicine to probiotics for irritable bowel syndrome-diarrhea:A systematic review and meta-analysis of randomized controlled trials

Objective:This study assessed whether Chinese herbal medicine(CHM)combined with probiotics/synbiotics for irritable bowel syndrome-diarrhea(IBS-D)was more effective and safer than probiotics/synbiotics alone.Methods:Ten databases were searched for randomized control trials(RCTs)of IBS-D as diagnosed by Manning or Rome criteria.Trials comparing probiotics and probiotics with CHM were included.The Cochrane risk of bias(ROB)was evaluated for each trial.RevMan 5.3 was used to conduct a meta-analysis.Results:Twenty-six RCTs were included(25 Chinese,1 English),involving 2045 participants.Metaanalysis was conducted on two outcomes:overall symptom improvement and relapse.CHM combined with live Bifidobacterium and Lactobacillus preparations reduced relapse rate(RR 0.28,95%CI 0.15e0.52,3 trials,n?205)compared with probiotics alone.The subgroup analysis showed the benefit of CHM prescriptions based on soothing liver and invigorating spleen(1.28,1.14e1.44,3,244),invigorating spleen and resolving dampness(1.20,1.03e1.41,2,128),or warming and invigorating spleen and kidney formulae(1.27,1.09e1.46,2,210)combined with triple Bifidobacterium preparations than the same probiotics alone which improved overall symptoms for IBS-D.There was unclear bias in almost domains of ROB.Most studies had a high risk of bias due to lack of blinding of investigator and participants,and selective reporting.Conclusions:This study showed that CHM combined with probiotics may reduce relapse rate by 72%,and improve overall symptoms of IBS-D(as diagnosed by Rome II and III)compared to probiotics alone.From the limited subgroup analysis,only soothing liver and invigorating spleen formulae,represented by Tongxie Yaofang,added to triple Bifidobacterium preparations may be superior to the single preparations in terms of overall symptoms.However,due to the poor methodological quality and small sample size of the trials,these findings must be interpreted with caution.