Clinical research report on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions(2022)

Objective:The paper is to comprehensively summarize and analyze the basic situation and methodological quality of clinical randomized controlled trials(RCTs)of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions published in 2022,to provide evidence and reasonable suggestions for the advancement of clinical research and the formulation of policies and guidelines.Methods:The Evidence Database System of clinical evidence-based evaluation of traditional Chinese medicine was searched,and data from China National Knowledge Infrastructure(CNKI),PubMed,and other databases were supplemented.The search duration was from January 1,2022,to December 31,2022.RCTs of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were included as the source of clinical evidence,and published information,sample size,intervention,control measures,treatment course,methodological quality,and key link report were analyzed and evaluated.Results:A total of 1,464 RCTs of traditional Chinese patent medicines were included,which comprised 667 types of traditional Chinese patent medicines;“traditional Chinese patent medicines+Western medicine vs.Western medicine”was the most widely used intervention and control setting,involving 417 RCTs(28.48%).A total of 245 RCTs of traditional Chinese classic famous prescriptions were included,comprising 55 types of traditional Chinese classic famous prescriptions.“Decoction+conventional treatment vs.conventional treatment”was the most widely used intervention and control setting,with 87 RCTs(35.51%).Published RCTs on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were limited by the study design and implementation.Most“allocation concealment”and“blinding of patients and personnel”were rated as medium to high risk.There are insufficient reports on key research links such as experimental registration and ethical approval.Conclusions:The number of RCTs on traditional Chinese patent medicines has decreased in 2022,but there has been a slight improvement in the research quality and impact.There are relatively few studies on traditional Chinese classic famous prescriptions.Measures must be taken to improve clinical trial design,implementation,and reporting.Methodological experts should be invited to provide professional technical guidance on the trial design.In the research implementation process,attention should be paid to quality control,particularly the standardization of the randomized execution.

Study on prescription medication mode and mechanism of traditional Chinese medicine in the treatment of noncritical COVID-19 based on data mining

Background:As of 2023,coronavirus disease 2019(COVID-19)is still spreading globally.Therefore,we aim to integrate non-critical COVID-19 high-frequency and high-targeting Chinese medicines to provide a reference for clinical prescriptions to improve COVID-19-related symptoms.Materials and methods:The information on non-critical COVID-19 high-frequency Chinese medicines in the diagnosis and treatment of COVID-19 was obtained by the TCM inheritance support platform.Using network pharmacology and molecular docking technology,high-targeting Chinese medicines with good docking activity with COVID-19 receptors angiotensin-converting enzyme-II(ACE2),3CLpro and tyrosine-protein kinase receptor UFO(AXL)were obtained.A new prescription for non-critical COVID-19 was established by integrating high-frequency and high-targeting Chinese medicines.Rats with acute lung injury induced by lipopolysaccharide were used as the experimental model.The histopathological changes in the lungs of rats in each group were observed by hematoxylin-eosin staining.The lung coefficient of rats was measured.The levels of IL-6,TNF-α,and IL-1βin serum were detected by enzyme-linked immunosorbent assay.The mRNA and protein levels of ACE2 and AXL in lung tissue were detected by real-time quantitative polymerase chain reaction and western blot.Results:Through data mining,it was found that there were 39 high-frequency traditional Chinese medicines for non-critical COVID-19 in the diagnosis and treatment guidelines.According to network pharmacology and molecular docking,30 highly targeted traditional Chinese drugs for COVID-19 were found.The new prescriptions for non-critical COVID-19 were comprehensively obtained,including Glycyrrhizae Radix,Ephedra Herba,Amygdalus Communis Vas,Gypsum Fibrosum,Descurainiae Semen,Atractylodes Lancea,Scutellariae Radix,Amomum Tsao-Ko Crevostet,Forsythiae Fructus,Pogostemon cablin,Magnolia Officinalis.Compared with the LPS-induced lung injury model group,the medium dose of the new prescription group had significantly alleviated pathological changes in lung tissue,decreased lung coefficient,decreased contents of IL-6,TNF-αand IL-1β,and increased mRNA and protein expression of ACE2 and AXL(P<0.05).Conclusion:Based on data mining,network pharmacology and molecular docking technology,the new prescription for non-critical COVID-19 established by this method has an anti-inflammatory effect on rats with acute lung injury induced by lipopolysaccharide and can provide a reference for clinicians to alleviate the symptoms related to non-critical COVID-19.

Summary of Zhang Hongxing's Experience in Treating Refractory Angina Pectoris with Traditional Chinese Medicine

As a famous traditional Chinese medicine(TCM)expert in Shandong province and a famous veteran TCM expert in Dezhou city,Zhang Hongxing has been engaged in cardiovascular clinical work for more than 30 years.He has unique experience in the treatment of refractory angina pectoris.This paper comprehensively explains from the aspects of etiology and pathogenesis.His treatment is mostly based on syndrome differentiation,combined with the basic pharmacology of modem Chinese medicine to formulate prescriptions and drugs,and at the same time values the use of insect drugs.We hereby attach the clinical records,hoping to provide reference for clinical workers,which is conducive to the inheritance and development of famous Chinese medical academic experience.

Traditional Chinese medicine Master XIONG Jibo’s medication experience in treating arthralgia syndrome through data mining

Objective This study aimed to examine and propagate the medication experience and group formula of traditional Chinese medicine(TCM)Master XIONG Jibo in diagnosing and treat-ing arthralgia syndrome(AS)through data mining.Methods Data of outpatient cases of Professor XIONG Jibo were collected from January 1,2014 to December 31,2018,along with cases recorded in A Real Famous Traditional Chinese Medicine Doctor:XIONG Jibo's Clinical Medical Record 1,which was published in December 2019.The five variables collected from the patients’data were TCM diagnostic information,TCM and western medicine diagnoses,syndrome,treatment,and prescription.A database was established for the collected data with Excel.Using the Python environment,a custom-ized modified natural language processing(NLP)model for the diagnosis and treatment of AS by Professor XIONG Jibo was established to preprocess the data and to analyze the word cloud.Frequency analysis,association rule analysis,cluster analysis,and visual analysis of AS cases were performed based on the Traditional Chinese Medicine Inheritance Computing Platform(V3.0)and RStudio(V4.0.3).Results A total of 610 medical records of Professor XIONG Jibo were collected from the case database.A total of 103 medical records were included after data screening criteria,which comprised 187 times(45 kinds)of prescriptions and 1506 times(125 kinds)of Chinese herbs.The main related meridians were the liver,spleen,and kidney meridians.The properties of Chinese herbs used most were mainly warm,flat,and cold,while the flavors of herbs were mainly bitter,pungent,and sweet.The main patterns of AS included the damp heat,phlegm stasis,and neck arthralgia.The most commonly used herbs for AS were Chuanniuxi(Cyathu-lae Radix),Huangbo(Phellodendri Chinensis Cortex),Cangzhu(Atractylodis Rhizoma),Qinjiao(Gentianae Macrophyllae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangqi(Astragali Radix),and Chuanxiong(Chuanxiong Rhizoma).The most common effect of the herbs was“promoting blood circulation and removing blood stasis”,followed by“supple-menting deficiency(Qi supplementing,blood supplementing,and Yang supplementing)”,and“dispelling wind and dampness”.The data were analyzed with the support≥15%and con-fidence=100%,and after de-duplication,five second-order association rules,39 third-order association rules,39 fourth-order association rules,and two fifth-order association rules were identified.The top-ranking association rules of each were“Cangzhu(Atractylodis Rhizoma)→Huangbo(Phellodendri Chinensis Cortex)”“Cangzhu(Atractylodis Rhizoma)+Chuanniuxi(Cyathulae Radix)→Huangbo(Phellodendri Chinensis Cortex)”“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)→Qinjiao(Gentianae Macrophyllae Radix)”and“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)+Huangbo(Phello-dendri Chinensis Cortex)→Qinjiao(Gentianae Macrophyllae Radix)”,respectively.Five clusters were obtained using cluster analysis of the top 30 herbs.The herbs were mainly dry-ing dampness,supplementing Qi,and promoting blood circulation.The main prescriptions of AS were Ermiao San(二妙散),Gegen Jianghuang San(葛根姜黄散),and Huangqi Chongteng Yin(黄芪虫藤饮).The herbs of core prescription included Cangzhu(Atractylodis Rhizoma),Chuanniuxi(Cyathulae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangbo(Phellodendri Chinensis Cortex),Mugua(Chaenomelis Fructus),Qinjiao(Gentianae Macro-phyllae Radix),Danggui(Angelicae Sinensis Radix),and Yiyiren(Coicis Semen).Conclusion Clearing heat and dampness,relieving collaterals and pain,and invigorating Qi and blood are the most commonly used therapies for the treatment of AS by Professor XIONG Jibo.Additionally,customized NLP model could improve the efficiency of data mining in TCM.

Professor Liu Guobin used traditional Chinese medicine to cure a case of primary erythema limb pain

Primary erythema limb pain is a very rare disease,and its pathogenesis is not clear.Usually,the pain symptoms of patients exist for a long time,which seriously affect the daily life of patients and increase the economic burden of patients.Professor Liu Guobin,who has been engaged in the diagnosis and treatment of peripheral vascular diseases for nearly 30 years,believes that heat-toxin and blood stasis collaterals are closely related to the disease,and emphasizes the principle of heat-toxin and evil qi causing the disease.It is emphasized that clearing heat and detoxification,promoting blood circulation and dispersing blood stasis are the main treatment principles.This paper selects a typical case to describe Professor Liu's clinical experience in the treatment of primary erythema limb pain by oral and external use of traditional Chinese medicine,so as to provide an effective method of traditional Chinese medicine for the treatment of primary erythema limb pain.

Validity and reliability of the evaluation tool of TCM confidence in students with TCM learning experience

Objective:This study aimed to design an evaluation scale of traditional Chinese medicine(TCM)confidence and then evaluate its validity and reliability.Methods:Three parallel samples with TCM learning experience were included in this current study.Randomly selected 500 nursing students were included factor analysis and reliability and validity analyses.After 4 weeks,200 nursing students were recruited to retest the reliability.The evaluation tool of TCM confidence included 6 dimensions and 25 entries.Results:Cronbach's a coefficient of the evaluation scale was 0.95 and that of the 6 observed aspects were higher than 0.90,and splithalf reliability was 0.81.For the retest reliability,Cronbach's a coefficient of the evaluation scale was 0.93 and that of the 6 examined aspects was all over 0.80.The index of content validity Scale Content Validity Index(S-CVI)was 0.92 and Item Content Validity Index(I-CVI)was 0.83–1.00.Conclusions:Observed results may indicate that the designed tool can be used to assess the TCM confidence level of students with TCM studied experience and also can evaluate results of TCM education during studying TCM lectures.

East to west:research progress in traditional Chinese medicine for antiaging strategies

Delaying the onset of aging is considered an important tool for dealing with the global crisis of the aging population.Accordingly,several antiaging studies have been conducted using strategies of modern medicine and traditional Chinese medicine(TCM).In this review,we summarize the current state of antiaging research related to both modern medicine and TCM and provide suggestions for further research.Various theories related to the aging process have been proposed,including the free radical theory,mitochondrial DNA damage theory,telomere theory,cross-linking theory,and intestinal flora theory,and a number of antiaging chemical treatments have been developed using modern medicine.These theories and achievements have resulted in major advancements in antiaging research.TCM is based on practical experience and has a long history with unique advantages in antiaging research.Some antiaging practices such as moderate diet consumption,acupuncture,Tai Chi(a traditional Chinese martial art that can relax the nerves to slow down the aging process),and Wuqin Xi(a traditional Chinese exercise to strengthen the body)have been adopted to maintain health.Several TCMs and prescriptions,particularly those related to medicine food homology,have been used in antiaging treatment,and their antiaging properties have been demonstrated to be effective based on pharmacological experiments and clinical applications.

An Empirical Case of Chinese Medicine in the Treatment of Idiopathic Edema

Idiopathic edema is a common,challenging,and complicated clinical condition with no recognized cause that is easy to prolong and repeat.Professor Li has a lot of expertise treating this condition.This condition is associated with a yang shortage in the spleen and kidneys,as well as a mutual accumulation of water and blood stasis.Zhenwu Decoction and Guizhi Fuling tablet are added to the prescription.Ms.Li’s clinical experience in the treatment of idiopathic edema is being shared with the fellow.

Experience inheritance from famous specialists based on real- world clinical research paradigm of traditional Chinese medicine

The current modes of experience inheritance from famous specialists in traditional Chinese medicine （TCM） include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.

An introduction of the experience in treating Ventricular premature beat with stasis heat

Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.

Zhou Lamei's Experience in Treating Gout

Chief physician Zhou Lamei performs diagnosis and treatment according to syndrome differentiation,and proposes the method of combining internal treatment with external treatment of traditional Chinese medicine and paying attention to the adjustment of eating habits and lifestyle,which has certain advantages in relieving acute attack,reducing uric acid,reducing gout complications caused by disease development and reducing adverse reactions of western medicine,and is of great significance to the treatment of gout onset and hyperuricemia control.

原发性干燥综合征合并血细胞减少中医诊治研究进展

原发性干燥综合征(pSS)是一种慢性炎症性自身免疫病,除累及外分泌腺之外,还可累及多器官、系统,其中以血液系统受累最为常见,多表现为一系或多系血细胞减少。目前对于pSS合并血细胞减少缺乏统一公认的治疗方案,西医治疗多以糖皮质激素、免疫抑制剂为主,而中医药治疗本病具有较好疗效。通过总结pSS合并血细胞减少的中医诊治经验,并对相关研究进行综述后发现,现代医家认为pSS核心病机为气阴亏虚,久之则产生热、毒、瘀等多种病理产物,相互影响,导致全身气血津液失常,引起血细胞减少。本病病位多责之于肝、脾、肾,治以滋阴、益气、养血之法,辅以清热解毒、化瘀通络之法,并根据其合并血细胞减少类型的不同以及是否使用糖皮质激素用药各有侧重。中医药治疗本病较西药治疗能够更好地改善血细胞水平且不良事件发生率更低,具有一定优势。

基于中医执业医师分阶段考试的中医学专业成绩分析与策略研究

[目的]总结和分析浙江中医药大学中医学专业学生的培养质量和存在问题,为中医药院校提高教学质量和学生临床知识及技能提供参考。[方法]以该校2018至2020年参加中医执业医师分阶段考试(第一阶段)实证研究的中医学专业学生为研究对象,采用方差分析和χ^(2)检验进行数据分析,比较分阶段考试成绩与在校学习成绩的相关性、考试通过率、掌握率。[结果]分阶段考试成绩能够较好地反映学生在校学习成绩情况,理论考试平均通过率为68.64%,技能考试平均通过率95.27%。理论考试平均总掌握率为65.06%,其中西医(基础医学类)55.57%、西医(临床医学类)52.12%,与理论考试总掌握率比较,差异有统计学意义(P<0.05);技能考试总掌握率为76.57%,第3~4站(体格检查)的平均掌握率分别为71.24%、72.24%。可以通过制定考试激励机制来提高学生考试内驱力,通过强化西医课程培训来提升理论考试通过率,通过反复临床技能训练来补齐技能考核的短板等改进措施和策略,从而提高学生的临床知识和技能,可为中医药院校提高教学质量作参考。[结论]中医药院校可以通过制定考试激励机制、强化西医课程培训、反复临床技能训练来提高学生的临床知识和技能,从而提高中医学专业学生的培养质量。

朱永康治疗分化型甲状腺癌术后并发症的经验

介绍朱永康教授治疗分化型甲状腺癌(DTC)术后并发症的临床经验。认为DTC术后的中医治疗分为早期和远期两个阶段,早期重在治“虚”,远期治疗除缓解其他治疗带来的毒副作用外,将“伏邪”理论引入治疗中,同时注重既病防变、已病防传和病愈防复。并附验案1则。

张婷婷治疗子宫腺肌症痛证经验

子宫腺肌症的发病率逐年上升,其治疗是临床的难点。张婷婷教授治疗子宫腺肌症痛证,根据“瘀阻于内,不通则痛”的基本病机,口服汤剂采用“柴芍方”以疏肝行气、活血止痛;“红藤方”以清热凉血、散瘀止痛;“清瘀温通方”以寒温并用、化瘀止痛;“扶正祛瘀方”以益气扶正、祛瘀止痛。张婷婷临证还结合灌肠、足浴的方法,内外合治,长期管理患者,效果显著。

许铣教授中西医结合治疗玫瑰痤疮的临证经验

许铣教授从事皮肤科临床、科研工作60余年,中西医结合治疗玫瑰痤疮经验丰富。许铣教授认为,肝郁血热、脾胃湿热为玫瑰痤疮的核心病机。治疗应以中药内服为主,结合疾病分型分期辨证论治,红斑与毛细血管扩张期的基本病因病机为肝失疏泄,郁而化热,基本治法为凉血疏肝兼以养阴清热;丘疹脓疱期主要以脾胃运化失司、脾胃湿热为主,治法为清热燥湿、解毒散结。病程日久者往往合并血瘀和湿热。外治中药常选择具有清热凉血、燥湿、解毒之药效及抑菌、控脂之药理作用的中药。同时,可以根据疾病的临床表现选用西药辅助治疗,临床疗效显著,附验案1例加以佐证。

基于数据挖掘分析倪青主任病证结合治疗Graves病遣方用药经验

目的探讨倪青主任病证结合治疗Graves病(Graves disease,GD)的遣方用药经验。方法收集就诊于倪青主任门诊的GD患者235例,结合患者临床症状和特异性理化检测指标将病情分为重度、中度、轻度和病情相对平稳的类型;中药处方235张,构建数据库,应用相关软件,分析病情与方剂及中药的关系。结果235例患者中重度7例,中度19例,轻度52例,病情平稳者157例;235张处方共涉及方剂40种,中药201味。频次统计提示重度使用最多为滋阴潜阳甲亢方;中度常用四逆散;轻度以参芪地黄汤为主;病情平稳最多用藿朴夏苓汤。201味中药中,使用频次高于10次的中药共59味,重度常用中药为夜交藤、生地黄、玄参、田基黄、栀子、牡蛎等;中度常用药为枳壳、厚朴、柴胡、香附等;轻度常用茯苓、太子参、炙甘草、生黄芪、白术、山萸肉等;病情平稳常用茯苓、泽泻、厚朴、猪苓、半夏、藿香、佩兰等。关联规则提示,支持度>10%,置信度>10%,作用度>1 h,病情与中药一项关联中与重度一起出现的为玄参、生地黄、夜交藤;中度为青皮;轻度为太子参。两项关联中与重度一起出现的为玄参、夜交藤;中度为青皮、陈皮;轻度为女贞子、旱莲草;病情平稳为牛蒡子、桔梗;仙茅、仙灵脾;荆芥、防风。三项关联中与中度一起出现的为漏芦、路路通、丝瓜络;轻度为太子参、生黄芪、生地黄;病情平稳为生薏米、苍术、田基黄;大腹皮、砂仁、莱菔子;香附、枳壳、赤芍;泽兰、泽泻、川牛膝。结论倪青主任病证结合治疗GD临床经验丰富,依据不同病情分度,分别采用滋阴潜阳、疏肝理气、益气养阴、健脾化痰、疏风利咽、利湿活血之法遣方用药。

孙克伟教授辨证论治肝病的经验探析

孙克伟教授在长期临床诊治中总结发现,多种肝病殊途同归,提出“补脾土,疏肝解郁”“逐湿邪,热无所依”“补先天,解毒袪邪”“调气血,瘀滞得化”“温脾阳,截断逆挽”的学术经验,临床应用效果显著。该文将从以上五法探析孙克伟教授辨证论治肝病经验,旨在为肝病中医诊疗提供参考和借鉴。

国医大师夏桂成论中医女性生殖节律理论的“节”和“律”

分述女性生命中五种节律(昼夜节律、周节律、月节律、年节律、生命节律)特征以及夏桂成教授基于生殖节律理论治疗妇科临床疾病的经验。昼夜节律是生命节律的基本单位,白天活动振奋阳气,夜间安睡静养阴血是最基本的养生准则。七为少阳数,女性的经期常持续7天,阴分充足“锦丝带”(像锦缎一样的阴道分泌物)也可达7天,更有助成孕。月经周期节律上应月下应潮,夏教授提出了经典的四期月经周期节律学说,后为了更好地描述阴阳变化,又将经典的四期分为七期,以更好地指导临床。并附验案1则。

马晓燕撷经典方剂治疗内科杂病经验浅谈

郁证的主要临床表现为情绪抑郁不宁、心胸满闷、胸部以及胁肋部胀痛,或有善哭易怒,亦或咽中如有炙脔等不适。相当于现代医学中的神经衰弱、癔症及焦虑症等。常因喜怒忧思,郁滞不舒,而导致肝疏泄功能失职,脾脏失其健运之功,心失其养,脏腑、气血、阴阳功能紊乱;而消渴常因禀赋不足亦或是饮食不节等因素导致阴津亏损,燥热偏盛,而出现“三多一少”的症状,即多饮、多尿、多食以及形体消瘦,相当于现代医学的“糖尿病”。马教授投身于对于郁证和消渴的证候及治疗的研究,熟读经典、精求古训,并且在长期的诊疗疾病过程中,对于使用经典方剂加减化裁辨治郁证和消渴等内科杂病积累了丰富的临床经验。现撷马教授以经典方剂治疗郁证和消渴等内科杂病的经验作总结与探析。其临床疗效确切。