Knee osteoarthritis:A review of animal models and intervention of traditional Chinese medicine

Background:Knee osteoarthritis(KOA)characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults.The pathophysiology of KOA remains poorly understood,as it involves complex mechanisms that result in the same outcome.Consequently,researchers are interested in studying KOA and require appropriate animal models for basic research.Chinese herbal compounds,which consist of multiple herbs with diverse pharmacological properties,possess characteristics such as multicomponent,multipathway,and multitarget effects.The potential benefits in the treatment of KOA continue to attract attention.Purpose:This study aims to provide a comprehensive overview of the advantages,limitations,and specific considerations in selecting different species and methods for KOA animal models.This will help researchers make informed decisions when choosing an animal model.Methods:Online academic databases(e.g.,PubMed,Google Scholar,Web of Science,and CNKI)were searched using the search terms“knee osteoarthritis,”“animal models,”“traditional Chinese medicine,”and their combinations,primarily including KOA studies published from 2010 to 2023.Results:Based on literature retrieval,this review provides a comprehensive overview of the methods of establishing KOA animal models;introduces the current status of advantages and disadvantages of various animal models,including mice,rats,rabbits,dogs,and sheep/goats;and presents the current status of methods used to establish KOA animal models.Conclusion:This study provides a review of the animal models used in recent KOA research,discusses the common modeling methods,and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.

Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

A systematic review of the efficacy of traditional Chinese medicine retention enema in the treatment of ulcerative colitis

The objective of this study is to summarize the efficacy and safety of traditional Chinese medicine(TCM)enema in the treatment of ulcerative colitis(UC).The randomized controlled trials on TCM enema intervention in the treatment of UC were searched in seven databases:PubMed,Embase,Web of Science,CBM,CNKI,Wanfang Database,and VIP Database from January 1,2013 to June 6,2022,and the data were analyzed using RevMan 5.3 software.A total of 18 studies involving 1514 UC patients were included.Meta analysis results showed that compared with conventional Western medicine,Chinese medicine enema had a significant effect on UC,and the clinical effective rate of the experimental group using Chinese medicine enema was 4.45 times that of the control group using conventional Western medicine(odds ratio=4.45,95%confidence interval[3.27,6.06]).Therefore,Chinese medicine enema is effective in the treatment of UC,and can significantly reduce related symptoms.

Application of Chinese Medicine Nursing Techniques in the Sequelae of Pelvic Inflammatory Diseases: A Review

Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.

Modified Xiaoyao powder for postpartum depression:A systematic review and meta-analysis

Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,Google Scholar,the SinoMed,Embase,Cochrane Library,and PubMed databases were searched from their inception to April 25,2023.The Cochrane Risk of Bias tool was used to assess the quality of the trials.We applied the risk ratio to present dichotomous data and the mean difference to present continuous data.Data with similar characteristics were pooled for meta-analysis and heterogeneity was assessed using I2.Results:This review included 35 trials involving 2848 participants.The quality of the included studies was low(unclear randomization processes and insufficient reporting of blinding).Participants treated with modified Xiaoyao powder plus Western medicine showed lower Hamilton Depression Scale(HAMD)depression score than those who used Western medicine alone(mean difference=-2.15;95%confidence interval:-2.52 to 1.78;P<.00001),and higher effective rate(relative risk=1.19;95%confidence interval:1.15 to 1.24;P<.00001),When comparing modified Xiaoyao alone with Western medicine,the HAMD depression score remained low,however,the efficacy rate was higher in the modified Xiaoyao group.Regarding adverse events,the modified Xiaoyao group reported weight gain,nausea,and diarrhea,but no severe adverse events were reported.Conclusion:Modified Xiaoyao may help relieve depression in PPD when used alone or in combination with Western medicine,with minor side effects.Therefore,future high-quality,large-sample size RCTs are warranted.

The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis

Objective To analyze the association between exposure to second-hand smoke(SHS) and 23 diseases,categorized into four classifications, among the Chinese population.Methods We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors(Chinese population), Exposure(SHS),Outcomes(Disease or Death), and Study design(Case-control or Cohort).Results In total, 53 studies were selected. The odds ratio(OR) for all types of cancer was 1.79(1.56–2.05), and for individual cancers was 1.92(1.42–2.59) for lung cancer, 1.57(1.40–1.76) for breast cancer, 1.52(1.12–2.05) for bladder cancer, and 1.37(1.08–1.73) for liver cancer. The OR for circulatory system diseases was 1.92(1.29–2.85), with a value of 2.29(1.26–4.159) for stroke. The OR of respiratory system diseases was 1.76(1.13–2.74), with a value of 1.82(1.07–3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household;For lung cancer, the OR was significant in women.Conclusion The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.

Comparative efficacy of traditional Chinese herbal injection for chronic renal failure:A systematic review and network meta-analysis of randomized controlled trials

Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction were conducted by 2 reviewers independently. NMA was performed by Stata 14.0, R 4.0.4 software, and the latest risk of bias assessment tool 2(RoB 2).Results: A total of 53 RCTs were finally included, involving 4445 participants and 16 CHIs. RoB 2 showed that 2 of these studies had a high risk of bias. Tianqi injection(TQ) + WM was the most effective in reducing serum creatinine(Scr) level. Xingding injection(XD) + WM was the most effective in reducing blood urea nitrogen(BUN) and cystatin C(Cys C) levels. Guhong injection(GH) + WM had the highest endogenous creatinine clearance rate(Ccr). Shuxuetong injection(SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection(DH) + WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ), while Danshen injection(DS) + WM led to the lowest blood uric acid(UA)level. Shenfu injection(SF) + WM was the most effective in increasing hemoglobin(Hb) level.Conclusion: CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators, SK + WM may be the optimal treatment option for improving renal function in patients with CRF.

Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy:A systematic review and network meta-analysis of randomized clinical trials

BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.

Traditional Chinese medicine for acute mountain sickness prevention: A systematic review and meta-analysis of randomized controlled trials

Objective: To evaluate the efficacy of traditional Chinese medicine(TCM) for preventing acute mountain sickness(AMS).Methods: We included randomized controlled trials(RCTs) which evalueded the effect of TCM for preventing AMS, compared with a placebo, no treatment or acetazolamide. The literature was searched in 6major databases. RevMan 5.4 software was used for the meta-analysis. The relative risk for discrete variables and the mean difference for continuous variables with 95% confidence intervals(CIs) were applied to express the effect size. The risk of bias in the included studies was evaluated using the Cochrane risk assessment tool 2.0(RoB 2.0), and the evidence certainty was assessed using the Grading of Recommendations Assessment and the Development and Evaluation(GRADE) approach.Results: Twenty RCTs involving 3015 participants and 16 TCM patent drugs were included. The overall risk of bias in the majority of studies(15/20) was of some concerns. In terms of the AMS incidence,Rhodiola rosea(R. rosea, Hong Jing Tian) and Ginkgo biloba(G. biloba, Yin Xing Ye) were equivalent to the placebo/no treatment [RR(95% CI): 0.66(0.43-1.01), 0.82(0.63-1.06), respectively]. The AMS incidence in the G. biloba group was higher than that in the acetazolamide group [RR(95% CI): 2.92(1.69-5.06)]. In terms of improving the AMS symptom score on days 1 and 3 in the plateau, R. rosea and G. biloba were superior to the placebo or no treatment [MD(95% CI):-0.98(-1.71,-0.25),-2.05(-3.14,-0.95), respectively]. The other 14 Chinese patent medicines were evaluated in a single trial, and the majority of the results were negative. The subgroup analysis showed that the effect of R. rosea was related to the intervention time, way of ascending, and altitude.Conclusion: R. rosea and G. biloba were effective in improving AMS symptoms but had no effect in reducing the AMS incidence. There was insufficient evidence to support the use of other TCM patent drugs to prevent AMS. More randomized double-blind placebo-controlled trials are warranted to evaluate and screen effective Chinese patent medicines for AMS prevention.

No country is an island in regulating food safety:How the WTO monitors Chinese food safety laws through the Trade Policy Review Mechanism(TPRM)

Established within the framework of the World Trade Organization （WTO）, the Trade Policy Review Mechanism （TPRM） reviews periodically the trade policies of all WTO Members. The review includes many aspects of food safety regulation. China＇s trade policy is reviewed every two years. This paper analyses in detail the reviews of China＇s trade policy in 2006, 2008, 2010, 2012 and 2014. It focuses in particular on food safety laws and types of standards, alignment of domestic standards with international standards, the role of different domestic institutions, transparency and notification of food safety measures under the WTO agreements on Sanitary and Phytosanitary Measures （SPS） and on Technical Barriers to Trade （TBTAgreement）, import and export, and geographical indications （GIs）. It concludes that the WTO TPRM can contribute, within its mandate, to reform of Chinese food safety laws and improvement of food safety in China. it notes that China has already undertaken substantial reforms of its system for regulating food safety. It recommends that China should continue to participate actively in the TPRM, follow its own path with regard to alignment and learn selectively from other WTO Members.

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.

Lung Cancer Risk Attributable to Active Smoking in China:A Systematic Review and Meta-Analysis

Objective No consensus exists on the relative risk(RR)of lung cancer(LC)attributable to active smoking in China.This study aimed to evaluate the unified RR of LC attributable to active smoking among the Chinese population.Methods A systematic literature search of seven databases was conducted to identify studies reporting active smoking among smokers versus nonsmokers in China.Primary articles on LC providing risk estimates with their 95%confidence intervals(CIs)for“ever”“former”or“current”smokers from China were selected.Meta-analysis was used to estimate the pooled RR of active smoking.Results Forty-four unique studies were included.Compared with that of nonsmokers,the pooled RR(95%CI)for“ever”“former”and“current”smokers were 3.26(2.79–3.82),2.95(1.71–5.08),and 5.16(2.58–10.34)among men,3.18(2.78–3.63),2.70(2.08–3.51),and 4.27(3.61–5.06)among women,and2.71(2.12–3.46),2.66(2.45–2.88),and 4.21(3.25–5.45)in both sexes combined,respectively.Conclusion The RR of LC has remained relatively stable(range,2–6)over the past four decades in China.Early quitting of smoking could reduce the RR to some extent;however,completely refraining from smoking is the best way to avoid its adverse effects.

Effect of health Qigong on rehabilitation of stroke patients:A systematic review and meta‑analysis

Objective:The objective of this study is to evaluate the effects of health Qigong on the rehabilitation of hemiplegic patients after stroke.Methods:The randomized controlled trials on health Qigong intervention in rehabilitation after stroke were searched in eight databases:PubMed,Cochrane Library,Embase,Web of Science,CBM,CNKI,Wanfang Database,and VIP Database from the inception to February 2022,and the data were analyzed using RevMan 5.3 software.Results:A total of 17 studies involving 1146 hemiplegic patients after stroke were included.Meta‑analysis results showed that the motor function and activities of daily living in the intervention group were better than those in the control group at different intervention times(intervention time<3 months and 3 months–24 weeks)(P<0.01).When the intervention time was<3 months,the improvement of balance function in the intervention group was better than that in the control group(P<0.01).However,when the intervention time was 3 months–24 weeks,there was no significant difference in the balance function between the intervention group and the control group(P=0.10).Conclusion:Health Qigong has a positive effect on the improvement of motor function and activities of daily living in hemiplegic patients after stroke,but the improvement of balance function is not sure.Due to the low overall quality of the included literature and the heterogeneity of some research results,more rigorous randomized controlled trials are needed to verify its efficacy.

Chinese medicine formulas for nonalcoholic fatty liver disease: Overview of systematic reviews

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)formulas.A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD.AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD.METHODS Seven databases were systematically searched from their inception to 28 February 2020.The search terms included“non-alcoholic fatty liver disease,”“Chinese medicines,”“systematic review,”and their synonyms.Systematic reviews involving TCM formulas alone or in combination with conventional medications were included.The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)and Risk of Bias in Systematic Review(ROBIS).The quality of outcomes was assessed by the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.RESULTS Seven systematic reviews were ultimately included.All systematic reviews were conducted based on randomized controlled trials and published in the last decade.According to the AMSTAR 2 tool,one systematic review was judged as having a moderate confidence level,whereas the other studies were rated as having a low or extremely low level of confidence.The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns.According to the GRADE system,only two outcomes were determined as high quality;namely,TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement,and TCM formulas were superior to antioxidants in alanine aminotransferase normalization.Other outcomes were downgraded to lower levels,mainly because of heterogeneity among studies,not meeting optimal information sample size,and inclusion of excessive numbers of small sample studies.Nevertheless,the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.CONCLUSION The quality of available systematic reviews was not satisfactory.Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.

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.

Chinese Herbal Medicine for Lung Cancer——A Critical Literature Review(Continued)

CLINICAL STUDIES Clinical studies on Chinese herbal medicine(CHM)in lung cancer(LC)have largely been on anumber of basic formulae selected by syndrome(Zheng)differentiation,or specific formula basedon clinical experience.There have also been anumber of studies comparing combination ofCHMs with either chemotherapy or radiotherapywith chemotherapy or radiotherapy alone,to as-sess any additional benefits or synergistic outcomesof the combination.

Effectiveness and Safety of Chinese Medicine in the Treatment of PostTACE Syndrome of Primary Hepatocellular Carcinoma:A Systematic Review

Objective:To systematically evaluate the effectiveness and safety of traditional Chinese medicine(TCM)in the treatment of posttransarterial chemoembolization(TACE)syndrome of primary liver cancer.Methods:CNKI,VIP database,Wanfang database,CBM,PubMed,MEDLINE,and Cochrane library were retrieved,and the RCTs of Chinese medicine in the treatment of primary liver cancer TACE postoperative syndrome were included from the establishment of the database to March 2022.The Cochrane bias risk tool was used to evaluate the quality of included articles.RevMan 5.4 software was used for metaanalysis of outcome indicators and GRADEprofiler 3.6 software was used to evaluate the quality of evidence.Results:A total of 3992 patients were included in 44 studies.Metaanalysis results showed that compared with conventional western medicine treatment,combined Chinese medicine treatment could reduce the incidence of fever[RR=1.45,95%CI(1.09,1.92)],nausea and vomiting[RR=1.47,95%CI(1.10,1.95)],liver pain[RR=1.21,95%CI(1.02,1.43)];shorten the duration of fever[SMD=2.11.95%CI(1.43,2.79)],nausea and vomiting[SMD=1.67,95%CI(1.22,2.11)],hepatic pain[SMD=1.90,95%CI(1.30,2.51)],abdominal distension and pain[SMD=1.27,95%CI(0.75,1.79)],loose stool[SMD=2.30,95%CI(1.24,3.36)],constipation[SMD=2.18,95%CI(1.52,2.84)]after TACE,also it can improve patient quality of life[RR=0.73,95%CI(0.65,0.82)],clinical TCM syndrome[RR=0.73,95%CI(0.65,0.82)],shortterm efficacy[RR=0.75,95%CI(0.66,0.85)],oneyear survival rate[RR=0.87,95%CI(0.78,0.96)]and liver function and immune function.There was no significant difference in the incidence of abdominal distension and abdominal pain.Conclusion:Compared with only symptomatic western medicine after surgery,the combination of Chinese medicine has a significant effect and good safety in the treatment of postTACE syndrome.

Chinese herbal medicine combined with nucleotide analogues for compensated HBV-related cirrhosis: a systematic review of randomized controlled trials

Objective:To systematically evaluate the effectiveness and safety of Chinese herbal medicine (CHM) plus nucleotide analogues (NAs) for treating compensated HBV-related cirrhosis,the early stage of cirrhosis.Methods:PubMed,Cochrane library,China Network Knowledge Infrastructure Database (CNKI),Chinese Scientific Journals Database (VIP),Wan Fang Database and Sino-Med Database were searched.Randomized controlled trials (RCTs) and quasi-RCTs comparing NAs and NAs plus CHM therapy on patients with compensated HBV-related cirrhosis were included.Two reviewers independently extracted information and assessed the methodological quality of the trials.Different CHM herbal formulas used in the trials were considered.Primary metaanalysis was conducted when there were at least two trials comparing the same CHM formula.Results:Forty-five trials comprising 3497 participants were included.The quality of most of the trials was moderate or low.Twenty-six herbal formulations were identified.A meta analysis was conducted for compound Biejia Ruangan (FFBJ),Dahuang Zhechong (DHZC),and Fuzheng Huayu (FZHY).The results of the subgroup analysis showed a beneficial effect of FFBJ plus entecavir (ETV),and DHZC plus adefovir dipivoxil (ADV) on hyaluronic acid (HA);FFBJ plus ADV on laminin (LN);and FZHY plus ADV on HA,LN,and precollagen type Ⅲ (PC-Ⅲ).The results from other studies suggested significant benefits of CHM plus NAs compared with NAs alone,except those on albumin (ALB).None of the trials evaluated the quality of life or reported severe adverse events.Conclusions:A positive effect was found for FFBJ plus ETV,DHZC plus ADV,and FZHY plus ADV on HA;FZHY plus ADV and FFBJ plus ADV on LN;and FZHY plus ADV on PCⅢ compared with the effects of NAs used alone.

Systematic Review and Meta-analysis on the Efficacy and Safety of Xuefu Zhuyu Oral Liquid(血府逐瘀口服液)in the Treatment of Migraine

Objective:To systematically evaluate the efficacy and safety of Xuefu Zhuyu Oral Liquid(血府逐瘀口服液)in the treatment of migraine.Methods:All randomized controlled trials(RCTs)on the treatment of migraine with Xuefu Zhuyu Oral Liquid were screened out by systematically searching Cochrane Library,Pub Med,Embase,Web of Science,VIP,Wanfang,CNKI and CBM database from database establishment to March 2023.Literature screening was conducted strictly according to inclusion and exclusion criteria,and the quality of the finally included RCTs was evaluated according to the Cochrane Handbook.All data analyses were completed using Rev Man 5.4 software provided by the Cochrane Collaboration.Results:A total of 8 RCTs involving 706 patients were included.Meta-analysis showed that Xuefu Zhuyu Oral Liquid alone(RR=1.22,95%CI[1.11,1.33],P<0.0001)or combined with conventional treatment(RR=1.19,95%CI[1.11,1.28],P<0.0001)was superior to conventional treatment alone in improving the severity of headache attacks and reducing recurrence.Three studies mentioned mild adverse reactions in individual patients during the treatment process,such as transient diarrhea,lethargy,etc.,which were not directly related to Xuefu Zhuyu Oral Liquid.Conclusion:Based on the existing data and meta-analysis results,Xuefu Zhuyu Oral Liquid alone or combined with conventional treatment can improve the total effective rate of migraine treatment,alleviate headache symptoms,reduce recurrence and adverse events.In the future,large-scale and high-quality original studies are needed to further verify the efficacy and safety of Xuefu Zhuyu Oral Liquid in the treatment of migraine,and provide a reference for the clinical medication of migraine.

Efficacy and safety of traditional Chinese medicine kidney-nourishing formula for Alzheimer's disease in comparison with donepezil:a systematic review and meta-analysis

Objective:Finding an effective therapy against Alzheimer’s disease(AD)has been associate increasingly pressing issue and traditional Chinese medicine(TCM)is widespread in the prevention and treatment of AD in China.The aim of this study was to judge the efficaciousness and safety of TCM kidney-nourishing(the changes of pathological state of kidney deficiency by means of TCM treatment and so on)formula(TKNF)for AD in comparison with donepezil.Methods:The retrieval period of seven databases was from the establishment of each database to April 2019.Two authors independently identified randomized controlled trials(RCTs),fetched data and assessed bias risk.Comprehensive analysis process was conducted with review manager for eligible and appropriate RCTs.Results:A complete of 981 AD patients from 13 studies were enclosed.Meta-analysis of RCTs showed that there was no significant difference in the improvement of Alzheimer's disease assessment scale-cognitive subscale score between 2 groups in short term,but the effect of long-term treatment may exceed donepezil;there was a significant difference in the improvement of activities of daily living score between 2 groups;there was a significant difference in TCM curative efficacy between 2 groups with long-term treatment.There was no significant difference in the incidence of adverse events between 2 groups.The quality of the evidence was high or moderate.Conclusion:Compared with donepezil,TKNF was an effective drug for AD patients and the clinical application of TKNF was safe.TKNF's long-term benefits need more evidence to verify.