Molecular mechanism and research progress of traditional Chinese medicine in the treatment of prostate cancer

Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and alternative medicine,shows unique advantages in cancer treatment.Chinese herbal medicine is usually composed of multiple ingredients and involves multiple signaling pathways,which showed function of inducing apoptosis of cancer cells,arresting the cell cycle,inhibiting invasion and metastasis,reducing drug resistance,and regulating immune function.Physical therapy is also an important treatment of TCM.Currently,Physical therapy such as acupuncture or Tai Chi and Qigong are gaining increased recognition in the management of PCa,particularly in addressing issues like urinary incontinence and bone metastasis-related pain.This article reviews the TCM treatment and therapy of PCa,in order to provide new research avenues and treatment options for the treatment of PCa with TCM and improve the quality of life of patients.

Developments in the study of Chinese herbal medicine's assessment index and action mechanism for diabetes mellitus

In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of experience,has been treating diabetes for over two millennia.Different antidiabetic Chinese herbal medicines re-duce blood sugar,with their effective ingredients exerting unique advantages.As well as a glucose lowering effect,TCM also regulates bodily functions to prevent diabetes associated complications,with reduced side effects compared to western synthetic drugs.Chinese herbal medicine is usually composed of polysaccharides,saponins,al-kaloids,flavonoids,and terpenoids.These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion,enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals.These actions regulate glycolipid metabolism in the body,eventually achiev-ing the goal of normalizing blood glucose.Using different animal models,a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer.Nonetheless,there is a dearth of scientific data about the pharmacology,dose-effect relationship,and structure-activity relationship of TCM and its constituents.Further research into the efficacy,toxicity and mode of action of TCM,using different metabolic and molecular markers,is key to developing novel TCM antidiabetic formulations.

Effects of Salinity and Dietary Chinese Herbal Medicine on Survival and Growth of Juvenile Fenneropenaeus chinensis

[Objective] The aim of this study was to provide theoretical basis for the large-scale breeding of Fenneropenaeus chinensis as well as the promotion of Chinese herbal medicine.[Method] The experiment was conducted to determine the effects of salinity（12‰,20‰ and 28‰）and dietary Chinese herbal medicine（CHM：0%,1%,2% and 4%）on survival and growth of juvenile F.chinensis with the average initial wet body weight of 0.027±0.005 g.The experiment lasted for 5 weeks.[Result] The survival rate,specific growth rate,food consumption and apparent digestibility coefficient was increased with CHM level increasing;when attained the critical value,the survival rate,specific growth rate,food consumption and apparent digestibility coefficient decreased with CHM level increasing.Food conversion ratio decreased with CHM level increasing,and then it increased after attained the critical value.At each CHM level,the survival rate,specific growth rate,food consumption and apparent digestibility coefficient were highest at salinity of 20‰,while food conversion ratio was lowest at salinity 20‰.[Conclusion] Salinity and CHM had a significant effect on growth of F.chinensis,which should be paid more attention in the breeding.

Effects of a Self-made Compound Chinese Herbal Medicine Additive on Growth Performance and Occurrence of Diarrhea in Weaned Piglets

In this study,the effects of compound Chinese herbal medicine on growth performance and occurrence of diarrhea in weaned piglets were investigated.A compound Chinese herbal medicine that consisted of Astragalus membranaceus,Codonopsis pilosula,Epimedium sagittatum,massa medicata fermentata,Atractylodes macrocephala,malt,Glycyrrhiza uralensis,Angelica sinensis and Crataegus pinnatifida,was crushed and then passed through a 500-mesh sieve.The obtained powder was added to the basal diet of weaned piglets.A total of 100 healthy crossbred weaned piglets,aging 26±2 days,were selected.They were randomly divided into 5groups（20 piglets/group） in according to principles of similar parity（3-5）,similar body weight and half male and half female.The piglets in the control group were fed with basal diet.For the piglets in the I,II and III groups,0.4%,0.7% and 1.0%of Chinese herbal medicine additive were added to the basal diets,respectively.The basal diet of piglets in the IV group was added with 30 mg/kg of oxytetracycline.The results showed the incidences of diarrhea in I,II and III groups were4.85%,5.14% and 5.63% lower than that of control groups（P〈0.05）.There was no significant difference in incidence of diarrhea between the control and the IV groups.

Isolation and Identification of the Pathogen Causing Skin Ulcer Disease in Cynoglossus semilaevis Günther and Its Sensitivity to Chinese Herbal Medicine

In this study, the pathogen causing skin ulcer disease in Cynoglossus semilaevis Gunther was isolated for morphological observation, physiological and bio- chemical identification. According to the result, the isolated pathogen was identified as Vibrio harveyi. The results of recurrent infection of C. semilaevis Gonther showed that the pathogen was strongly pathogenic to C. semilaevis Gunther. In or- der to explore the pathogenesis, outer membrane protein （OMP） gene of C. semi- laevis Gunther was detected by PCR. The results showed that all the three repre- sentative strains harbored OMP gene. According to the results of sensitivity test of the pathogen to Chinese herbal medicine, Galla Chinensis, Fructus Mume, Fructus Hippophae and Lignum Sappan exerted strong antibacterial effects against V. harveyr, Pericarpium Granati exhibited slight antibacterial effect against V. harveyi; Pericarpium Citri Reticulatae, Rhizoma Acori GramineL Herba Houttuyniae, Herba Portulacae, Herba Andrographis, Eucalyptus globulus Labill. and Herba Menthae Heplocalycis had little effect on V. harveyi. Galla Chinensis, Fructus Mume, Fructus Hippophae and Lignum Sappan were prepared into three prescriptions, among which prescription 1 （Galla Chinensis ＋ Fructus Mume） exhibited the strongest antibacterial effect.

Effects of Salinity Fluctuation and Dietary Traditional Chinese Herbal Medicines on Survival,Growth and Immunity of Exopalaemon carinicauda

[Objective]The aim of this study was to provide a theoretical basis for the large-scale breeding of Exopalaemon carinicauda. [Method]Effects of salinity fluctuation （S0,S3,S6 and S9 represented salinity fluctuations of 0,3,6 and 9 respectivley） and dietary traditional Chinese herbal medicines （0,1%,2% and 4% respectively） on survival,growth and immunity of E.carinicauda were studied,and its experiment lasted for 60 d. [Result]The results showed that specific growth rate,feed conversion efficiency and superoxide dismutase activity of E.carinicauda in the treatment group with 1% dietary traditional Chinese herbal medicine and S6 salinity fluctuation were higher than those in other treatments,which was significantly higher than the treatment groups with S0,S3 and S9 salinity fluctuation at the same adding level of 1% dietary traditional Chinese herbal medicine. The regression analysis indicated that at S0,S3 and S6 salinity fluctuation,the optimal adding level of dietary traditional Chinese herbal medicines in feeds decreased with the increase of salinity fluctuation,accounting for 2.74%,1.77% and 0.51% respectively. At four adding levels of dietary traditional Chinese herbal medicines,the optimal salinity fluctuation of E.carinicauda also decreased with the increase of dietary traditional Chinese herbal medicines in feeds,accounting for 5.26,4.95,3.54 and 1.97 respectively. [Conclusion]Salinity,dietary traditional Chinese herbal medicines and their interactions have a significant effect on survival,growth and immunity of E.carinicauda,which calls for attentions in the breeding.

Chinese Herbal Medicine Resources with Bacteriostatic and Insecticidal Activities and Their Application as Pesticides

Herbal pesticides refer to the active ingredients extracted from herbs which are used for pest and disease control in crops or pure substances isolated from them. They are of great significance for the production of pollution-free agricultural products, as well as for exploiting the abundant plant resources in China for the prevention and control of pests. In this paper, the advantages of herbal pesticides,such as being environment-friendly, diverse patterns of action, safety for higher animals and the natural enemies of pests and making it hard for pests to produce resistance were first stated; then, Chinese herbal medicine resources with antibacterial and insecticidal activities from 49 families and their functions were reviewed, and 19kinds of herbal pesticides that have been developed and applied in China and seven kinds that have been produced on a large scale were also introduced; finally,three issues deserving further exploration during the development and application of herbal pesticides were presented, that is, research in variety selection and cultivation of herbs, and methods for extraction of active ingredients; basic research in the structure identification of herbal active ingredients, and the relationship between plant variety and active ingredients; development of lead compounds based on herbal active ingredients.

Screening of Chinese Herbal Medicines Resistant to Chicken Escherichia coli and Infectious Laryngotracheitis Virus

[Objective] This study aimed to screen Chinese herbal medicines resistant to Chicken Escherichia coli and infectious laryngotracheitis virus. [Methed] Conven- tional punch method, test tube method and plate dilution method were adopted for in vitro susceptibility test of chicken E, coil strains O5 and O8 using 13 kinds of Chi- nese herbal medicines including Sanguisorba officinalis, Coptis chinensis, Anemar- rhena asphodeloides, Strobilanthes cusia, Agastache rugosa, etc.; chicken embryo inoculation experiment was adopted to screen Chinese herbal medicines resistant to chicken infectious laryngotracheitis virus. [Result] Sanguisorba officinalis, Fructus mume, Rheum officinale, Coptis chinensis, Herba Taraxaci, Anemarrhena asphode- Ioides, Scutellaria baicalensis and Rhizoma Fagopyri Cymosi had ideal antibacterial effect against chicken E. coil strain O5; Sanguisorba officinalis, Fructus mume, Rheum officinale, Coptis chinensis, Herba taraxaci and Rhizoma Fagopyri Cymosi had ideal antibacterial effect against chicken E. coil strain 08; other Chinese herbal medicines showed relatively poor or no antibacterial effect. Results of chicken embryo inoculation experiment showed that nine kinds of Chinese herbal medicines showed relatively strong anti-lLTV effect, including Forsythia suspensa, Radix Isatidis, Fofium isatidis, Flos Ionicerae, Radix codonopsis, Radix astragali, Atractylodes, Radix gly- cyrrhizae, and Pericarpium granati. [Conclusion] The study laid the foundation for fur- ther development of Chinese herbal compound preparations to treat chicken cofibacil- Iosis, infectious laryngotracheitis and other bacterial, viral diseases.

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.

Model informed precision medicine of Chinese herbal medicines formulas-A multi-scale mechanistic intelligent model

Recent trends suggest that Chinese herbal medicine formulas(CHM formulas)are promising treatments for complex diseases.To characterize the precise syndromes,precise diseases and precise targets of the precise targets between complex diseases and CHM formulas,we developed an artificial intelligence-based quantitative predictive algorithm(DeepTCM).DeepTCM has gone through multilevel model calibration and validation against a comprehensive set of herb and disease data so that it accurately captures the complex cellular signaling,molecular and theoretical levels of traditional Chinese medicine(TCM).As an example,our model simulated the optimal CHM formulas for the treatment of coronary heart disease(CHD)with depression,and through model sensitivity analysis,we calculated the balanced scoring of the formulas.Furthermore,we constructed a biological knowledge graph representing interactions by associating herb-target and gene-disease interactions.Finally,we experimentally confirmed the therapeutic effect and pharmacological mechanism of a novel model-predicted intervention in humans and mice.This novel multiscale model opened up a new avenue to combine“disease syndrome”and“macro micro”system modeling to facilitate translational research in CHM formulas.

Unveiling the anticancer effect of traditional Chinese herbal medicine

In this issue of World Journal of Gastroenterology,Huang et al reported that Calculus bovis(CB),a traditional Chinese herbal medicine,impedes the growth of liver cancers in vivo.Through further in vitro studies,they showed that CB suppressed the M2 polarization of tumor-associated macrophages by suppressing the Wnt signaling pathway,which consequently inhibited the growth of liver cancer.Although the effects of traditional Chinese herbal medicine are often not scientifically proven,Huang et al successfully identified the molecular mechanism involved in the anticancer effect of CB,and it is anticipated that the molecular mechanisms involved in the effects of other traditional Chinese herbal medicines will be scientifically elucidated,as demonstrated in this article.

Integration of traditional,complementary,and alternative medicine with modern biomedicine:the scientization,evidence,and challenges for integration of traditional Chinese medicine

Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into current healthcare systems.This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine,further termed here as“scientization”.Specifically,we aim to summarize the advancements made in understanding the efficacy,effectiveness,and underlying mechanisms of herbal medicine.We also examined the transition from experience-to evidence-based medicine during acupuncture.Furthermore,we explore the development of universal safety and quality control standards.Finally,we discuss international trade and export markets for Chinese medical products.The development and integration of traditional medicine have allowed it to further improve human health,resulting in a more comprehensive health solution for the global population.

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

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.

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study

AIM To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine(TCM) in order to evaluate the frequency of newly detected liver injury.METHODS Patients with normal values of alanine aminotransferase(ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method(RUCAM) was used.RESULTS This report presents for the first time liver injury data derived from a prospective, hospital-based and largescale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to < 5 × upper limit normal(ULN) in 844 patients(3.93%) and suggested mild or moderate liver adaptive abnormalities. However, 26 patients(0.12%) experienced higher ALT values of ≥ 5 × ULN(300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. CONCLUSION In 26(0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

Effects of Chinese herbal medicine on plasma glucose,protein and energy metabolism in sheep

Background： The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in the past two decades and played an increasingly important role in livestock production. The present study was carried out to assess the feeding effects of a traditional nourishing Chinese herbal medicine mixture on kinetics of plasma glucose, protein and energy metabolism in sheep. Ruminal fermentation characteristics were also determined. Methods： Four sheep were fed on either mixed hay （MH-diet） or MH-diet supplemented with 2% of Chinese herbal medicine （mixture of Astragalus root, Angelica root and Atractylodes rhizome; CHM-diet） over two 3S-day periods using a crossover design. The turnover rate of plasma glucose was measured with an isotope dilution method using [U-^13C]glucose. The rates of plasma leucine turnover and leucine oxidation, whole body protein synthesis （WBPS） and metabolic heat production were measured using the [1-^13C]leucine dilution and open circuit calorimetry. Results： Body weight gain of sheep was higher （P = 0.03） for CHM-diet than for MH-diet. Rumen pH was lower （P = 0.02）, concentration of rumen total volatile fatty acid tended to be higher （P = 0.05） and acetate was higher （P = 0.04） for CHM-diet than for MH-diet. Turnover rates of plasma glucose and leucine did not differ between diets. Oxidation rate of leucine tended to be higher （P = 0.06） for CHM-diet than for MH-diet, but the WBPS did not differ between diets. Metabolic heat production tended to be greater （P = 0.05） for CHM-diet than for MH-diet. Conclusions： The sheep fed on CHM-diet had a higher body weight gain and showed positive impacts on rumen fermentation and energy metabolism without resulting in any adverse response. Therefore, these results suggested that the Chinese herbal medicine mixture should be considered as a potential feed additive for sheep.

Quality Inspection and Preparation of Diarrhea Arresting and Dysentery Treating Dietary Traditional Chinese Herbal Medicine for Livestock

[Objective] This study was aimed to formulate the quality inspection of diarrhea arresting and dysentery treating dietary traditional Chinese herbal medicines for livestock.[Methods] Physiochemical identification and contrast test of UV spectrophotometer qualitative detection were adopted.[Results] The difference in the peak value of maximum adsorption peak detected by diluted water method was greater than 1 nm; the maximum adsorption peak values obtained by the 0.9％ hydrochloric acid and 60％ ethanol methods had a difference of less than 1 nm,and the secondary adsorption peak values also had a difference of less than 1 nm.[Conclusion] The 0.9％ hydrochloric acid and 60％ ethanol methods were selected as the quality inspection standards for the preparation of diarrhea arresting and dysentery treating dietary traditional Chinese herbal medicines for livestock.

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.

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.