Heterogeneity of Outcomes Reporting in Trials Evaluating Traditional Chinese Medicine Breast Massage for Stasis Acute Mastitis: A Methodological Review

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI,Wanfang,VIP,Sino Med,Pub Med,Web of Science,Embase,Cochrane library,JBI,CINAHL,Psyc INFO,Clinical Trials Registry Platform portal,Clinical Trials Registry,Australian New Zealand Clinical Trials Registry,Center Watch Registry from inception to May 15,2022 to find randomized controlled trials,non-randomized controlled trials,case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage,with search terms of mastitis,acute mastitis,lactation mastitis,puerperal mastitis,breast problem,breast engorgement,milk stasis,blocked ducked,breast pain,breast massage,and acupoint massage.Outcomes and the measurement schemes(measurement methods,timing of assessing outcome,frequency of assessing outcome,measurers)were extracted from the included studies.We used the Management of Otitis Media with Effusion in Children with Cleft Palate(MOMENT)to assess the quality of each study,then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials(OMERACT)Filter 2.1 framework.Results We identified 85 clinical trials,in which 54 different outcomes were reported.A total of 81.2%(69/85)of studies were assessed as medium quality with a mean score of 2.6,and 18.8%(16/85)as low quality with a mean score of 0.9.These outcomes were organized in three core areas.Lump size(89.4%,76/85)was the most frequently reported outcome,followed by breast pain(69.4%,59/85)and milk excretion(68.2%,58/85).Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous.Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.

Novel technologies and models for studying pharmacological activities of traditional Chinese medicine for promoting blood circulation and removing blood stasis

OBJECTIVE Our previous studies demonstrated that various ingredients from the traditional Chinese medicine(TCM)for promoting blood circulation and removing blood stasis,as exemplified by cryptotanshinone and salvianolic acid B,exerted striking effects on modulating angiogenesis and vascular permeability,which suggests that they may be effective in treating vascular leak-driven diseases(e.g.tumor,cerebral cavernous malformation and diabetic retinopathy).However,the lack of reliable and advanced technologies and models sets up difficult hurdles for better understanding the role of TCM for promoting blood circulation and removing blood stasis.To this end,this study is to outline numerous cutting-edge platforms that can be utilized for exploring the function of TCM for promoting blood circulation and removing blood stasis in vascular leak-driven diseases.METHODS Two-photon laser scanning fluorescence microscopy was used to observe the interactions between neutrophils and blood vessels in a real-time manner.Dynamic flow system was employed to mimic the in vivo behaviors of neutrophils.RIP1-Tag5 spontaneous pancreatic cancer model was used to study the function of tumor blood vessels.CCM2ECKO(deletion of CCM2 in endothelial cells)mice were employed to establish the cerebral cavernous malformation(CCM)animal model.Micro-computed tomography(micro-CT)was utilized to assess the CCM lesion.Müller cell-knockout mouse model was used to study the progression of diabetic retinopathy.Vascular permeability in this model was assessed by fluorescein angiography.RESULTS The interactions between neutrophils and endothelial cells involve a series of complicated processes,including rolling,adhesion,intraluminal crawling and transmigration,which were all monitored in vivo by two-photon laser scanning fluorescence microscopy in a real-time manner.Dynamic flow system was capable of recapitulating the biological behaviors of neutrophils in vitro.Tumor vascular function in particular vascular perfusion could be assessed in the RIP1-Tag5 spontaneous pancreatic cancer model.In terms of CCM studies,specific deletion of CCM2 in endothelial cells resulted in the initiation of CCM lesion.The size and number of CCM lesions could be visualized and quantified by micro-CT.Furthermore,the Müller cell-knockout mouse model was able to precisely reflect the clinical symptoms of diabetic retinopathy.Vascular leak could be monitored at different time points using fluorescein angiography.CONCLUSION An array of high technologies and animal models can be used in investigating the occurrence and progression of multiple vascular leak-driven diseases.The pre-clinical and clinical studies of TCM for promoting blood circulation and removing blood stasis provide fundamental support for the application of the above-mentioned platforms,with the purpose of uncovering the scientific basis of TCM for promoting blood circulation and removing blood stasis.

Treatment for non-alcoholic steatohepatitis with type 2 diabetes by traditional Chinese medicine:a case report and experience

Non-alcoholic fatty liver disease and type 2 diabetes are common comorbidities or target organ damage,which can lead to adverse metabolism and increased risk of cardiovascular and cerebrovascular diseases.In the management plan of non-alcoholic fatty liver disease and type 2 diabetes,there is no drug with significant efficacy or both.The dialectical idea of traditional Chinese medicine has a good curative effect and significant advantages in treating metabolic disorders.The author now reviewed a case of non-alcoholic steatohepatitis combined with type 2 diabetes.In this case,the method of invigorating the spleen and eliminating turbidity was effective,which effectively prevented the progression of liver disease in the patient,and T2DM was alleviated by maintaining within the standard range after the use of insulin was stopped.It can be said that“killing two birds with one stone”,more fully reflects the advantages of traditional Chinese medicine in the integrated treatment of metabolic-related diseases.

Research progress of traditional Chinese medicine in the treatment of breast cancer based on “Binding of Phlegm and Stasis”

Breast cancer is a common malignancy in female,which seriously endangers women’s health.Chinese medicine believed that the incidence of breast cancer is related to“Stagnation of Liver-Qi”and“Phlegm,Disharmony of Thoroughfare and Conception Vessels”,“Stagnation of Qi and Blood Stasis”,constitution and other characteristics.Modern research believed that phlegm is related to abnormal energy metabolism of tumor cells,and stasis is the pathological change of tumor angiogenesis.How to combine tumor angiogenesis and energy replacement abnormality with the theory of“Binding of Phlegm and Stasis”has become a new direction of traditional Chinese medicine anti-tumor research.The drugs of“Activating Blood Circulation”and“Removing Blood Stasis”,“Resolving Phlegm”and“Dispersing Constipation”have a wide range of pharmacological effects and definite curative effect.They have the functions of anti-inflammatory,anti-tumor,anti-pathogenic microorganism and improving the immune ability of the body.In this paper,the effects and mechanisms of phlegm-reducing and stasis dispersing active ingredients and compound preparations in regulating angiogenesis and energy metabolism of breast cancer were reviewed,and the differences in efficacy,targets and pathways of Phlegm-Reducing and Stasis Dispersing drugs were summarized,so as to provide some reference for the research and development of traditional Chinese medicine for breast cancer.

Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

Objective: to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen (FIB) and D-dimer (DD) in plasma of patients with cerebral thrombosis. Method: 73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases. The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment. Result: FIB content in plasma after treatment was lower than that before treatment in the control group (P<0.01) and more remarkable in the treatment group (P<0.001). There was an obvious difference in DD content before and after treatment in both groups. DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group (P<0.01 and P<0.05 respectively). Conclusion: Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis, raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

Analysis on the rules of prescriptions for ischemic stroke based on the traditional Chinese medicine inheritance auxiliary system

In China,traditional Chinese medicine is widely used in the treatment of ischemic stroke,but its prescription rules needs to be further studied.This paper uses the traditional Chinese medicine inheritance auxiliary system(a software)to analyze the composition rules of a large number of prescriptions for the treatment of ischemic stroke,and discusses the clinical rationality of the new prescriptions.We found that the prescriptions for the treatment of ischemic stroke are mainly composed by herbs for promoting blood circulation and removing blood stasis,dredging collaterals and tonifying deficiency,and some of the new prescriptions are also in line with this characteristic.This paper can provide reference for clinical prescription in the treatment of ischemic stroke and the development of related new drugs.

Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease:a systematic review and Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD).METHODS:We searched randomized controlled trials(RCTs) from eight databases.RESULTS:Sixteen eligible studies with 1,356 participants were included in this study.Compared to treatment with Western Medicine(WM) alone,the combined treatment with activating blood circulation and removing blood stasis in terms of TCM(ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen(C-Ⅳ)(SMD:-2.17,95% CI:3.01 to-1.34),type Ⅲ procollagen(PC-Ⅲ)(SMD:-1.08,95% CI:-1.64 to-0.53),laminin(LN)(SMD:-1.28,95% CI:-1.65 to-0.90),transforming growth factor β 1(TGF-β1)(SMD:-0.65,95% CI:-1.18 to-0.12),serum creatinine(Scr)(SMD:-1.36,95% CI:-1.85 to-0.87),blood urea nitrogen(BUN)(MD:-1.51,95% CI:-2.59 to-0.43),and 24 h urine protein(24h Upro)(SMD:-1.23;95% CI:-1.96 to-0.50).The level of hyaluronic acid(HA) was similar in both types of treatment(SMD:-0.74,95% CI:-1.91 to 0.44).The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ,PC-Ⅲ,and LN(P < 0.05).The effectiveness of the longer duration to C-Ⅳ,PC-Ⅲ,and LN was not certain.However,the result should be interpreted in care.The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects.The results of the Meta-analysis were not stable enough.There was publication bias for the reports on Scr(P = 0.001),C-Ⅳ(P = 0.001),PC-Ⅲ(P = 0.026),and LN(P = 0.030) and no publication bias for the reports on BUN(P = 0.293).The quality of evidence varied from low to very low.CONCLUSIONS:The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone.High-quality RCTs need to be conducted for the strong support.

Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome:a network Meta-anal

OBJECTIVE:To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegmstasis coronary heart disease by a network Meta-analysis.METHODS:Randomized controlled trials(RCTs)on clinical efficacy of CHD angina pectoris with interaction of phlegm and blood stasis were searched in PubMed,Springer,the Cochrane Library and Chinese-language databases China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data from their inception to December 2021.Literature was screened and literature bias risk was assessed by RevMan5.4 software.The overall response rate,the duration of angina attack,the levels of serum lipids such as total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C),and expression of hypersensitive C-reactive protein(hs-CRP)were selected as outcome indicators for network Meta-analysis and mapped using Stata15.1 software.RESULTS:Totally,26 RCTs were included,involving 2098 participants.There were 6 TCM formulas with the effects of dispelling phlegm and removing blood stasis.Taking conventional Western Medicine as the common intervention measures,the results showed that the overall response improvement rate from high to low was displayed as modified Xiaoxianxiong decoction(小陷胸汤,MXD),Danlou tablet(丹蒌片,DT),modified Gualou Xiebai Banxia decoction(瓜蒌薤白半夏汤,MGXBD),modified Wendan decoction(温胆汤,MWD),modified Zhishi Xiebai Guizhi decoction(枳实薤白桂枝汤,MZXGD),and modified Erchen decoction(二陈汤,MED).The sequence of angina attack duration improvement from high to low was MZXGD,MGXBD,DT,MWD,MXD.The sequence of TC improvement from high to low was MZXGD,MED,DT,and MGXBD.Sequence of improving TG from high to low was MED,MZXGD,MGXBD,and DT.For LDL-C improvement,the effect from good to poor was MZXGD,MGXBD,DT,and MED.With regard to HDL-C improvement,the effect was ranked as MED,MZXGD,MGXBD,and DT from good to poor.hs-CRP expression from high to low was MZXGD,MXD,MED,MWD,and MGXBD.CONCLUSION:TCM formula with the effects of dispelling phlegm and removing blood stasis combined with conventional Western Medicine has obvious advantages in treating CHD angina pectoris with interaction of phlegm and blood stasis.MZXGD has great potential in increasing the overall response rate,reducing Duration of angina attack improving blood lipids,and reducing inflammatory factors.However,due to the limitations of extant studies,the conclusions of this study need to be confirmed by numerous reasonably-designed RCTs.

Pharmacokinetics of traditional Chinese syndrome and recipe:a hypothesis and its verification(Ⅰ)

AIM To propose a hypothesis defining theabsorption,distribution,metabolism andelimination of traditional Chinese recipe（TCR）-component in blood of healthy subjects andpatients,and estimate its correctness.METHODS The pharmacokinetics（PK）of samedose of drug was studied in the animal model oftraditional Chinese syndrome（S）and healthyanimals.The classification,terminology,concept and significance of the hypothesis wereset forth with evidence provided in the presentstudy.The hypotheses consisted of traditionalChinese syndrome PK（S-PK）and traditionalChinese recipe PK（R-PK）.Firstly,the observedtetramethylpyrazine（TMP）PK in healthy,chronically reserpinized rats（rat model ofspleen deficiency syndrome,RMSDS）andRMSDS treated with Sijunzi decoction（SJZD）forconfirmation were used to verify S-PK; secondly,the ferulic acid（FA）PK in healthy andhigh molecular weight dextran（HMWD）-inducedrabbit model with blood stasis syndrome（RDBSS）was also used to verify S-PK;andlastly,TMP PK parameters in serum of healthyrats after orally taken Ligusticum wallichii（LW）,LW and Salvia miltiorrhiza（LW&SM）decoctions were compared to verify R-PK.RESULTS The apparent first-order absorption[Ka,（13.61±2.56）h-1,area under the blooddrug concentration-time curve[AUC,（24.88±9.76）μg.h-1mL-1],maximum drug concentration[Cmax,（4.82±1.23）μg·mL-1]of serum TMP inRMSDS were increased markedly（P【0.05）compared with those[Ka=（5.41±1.91）h-1,AUC=（5.20±2.57）μg·h-1·mL-1,Cmax=（2.33±1.77）μg·mL-1]of healthy rats（HR）.Theapparent first-order rate constant for α and βdistribution phase[α=（0.38±0.09）h-1,β=（0.06±0.03）h-1,the apparent first-orderintercompartmental transfer rate constants[K10=（0.24±0.07）h-1,K12=（0.11±0.02）h-1,K21=（0.11±0.02）h-1]of serum TMP in RMSDS weredecreased significantly（P【0.01）comparedwith those[K10=（0.88±0.20）h-1,K12=（1.45±0.47）h-1,K21=（0.72±0.22）h-1]of HR.However,no apparent differences occurredbetween HR and RMSDS treated with SJZD.Theserum FA concentration and its AUC[（5.6690±2.3541）μg·h-1·mL-1] in RMBSS were also higherthan those[AUC=（2.7566±0.8232）μg·h-1·mL-1]of healthy rabbits（P【0.05）.The Ka（11.51±2.82）h-1,AUC（0.84±0.17）μg·h-1·mL-1of LW & SM-derived TMP in serum weremuch lower（P【0.05）than those[Ka=（19.58±4.14）h-1,AUC=（1.27±0.26）μg·h-1·mL-1]ofLW-derived TMP in serum after oral decoctions.CONCLUSION The SDS and blood stasissyndrome state could affect significantly thepharmacokinetic parameters of drugs and theabnormal SDS pharmacokinetic parameters couldbe normalized by SJZD.The combination ofChinese medicine in TCR could reciprocallyaffect the pharmacokinetic parameters of othercomponents absorbed into the systemiccirculation.These results support the S-and R-PK hypothesis.

Treatment of Obesity with Western Medicine and Traditional Medicine:Based on PubMed and Science Direct Databases

The objective of this review was to collect the current published research on obesity and gain insight into the association of treatment based on a global aspect.The first section of the review will cover the treatment of obesity based on a Western medicine lens.The second section of the review will cover the treatment through a traditional approach based from different regions of the world(not including China).The third section of the review will cover treatment through a traditional Chinese medicine approach.The most commonly used electronic databases were used to search for articles related to obesity.The articles gathered consist of a broad spectrum from various parts of the world.Terms used in the search bar consisted of“obesity”,“BMI”,“acupuncture”,“traditional Chinese medicine”,etc.The majority of findings were collected from treatment based on both a western medicine and traditional Chinese medicine approach.The published literature collected is predominantly sourced from the online journal databases PubMed and Science Direct.Obesity is an ever-growing issue throughout society today.Different methods have shown effective results in treating this disease.It is crucial to continue exploring different treatment methods in hopes to solve this major public health issue.

Clinical Research on the Treatment of Simple Obesity by Oral Chinese Medicine Combined with Health Education to Improve Phlegm Dampness Constitution

OBJECTIVE: To observe the clinical effect of oral traditional Chinese medicine granules combined with health education to regulate phlegm constitution and treat simple obesity. METHODS: According to the method of constitution evaluation in TCM Constitution Classification and Evaluation(Chinese Association of Chinese Medicine), the TCM classification of Chinese medicine was performed on patients who came to the outpatient department of the Traditional Chinese Medicine Hospital of Pinggu District of Beijing and met the diagnostic criteria of simple obesity. One hundred patients with phlegm constitution were selected and those in accordance with the standards, were randomly divided into group with oral TCM granules combined with health education(refer to as treatment group) and health education group(refer to as control group) according to 1:1 ratio. The control group was given health education including diet and exercise instruction. Treatment group:(1) Health education includes diet and exercise instruction.(2) Oral Chinese medicine granules: ingredients: atractylodes rhizome 15g, raw barley 30g, Folium Nelumbinis 10g, Chinese hawthorn fruit 10g, Chinese waxgourd peel 15g, milk-vetch root;15g, kudzuvine root 15g, danshen root10g, 2 times/d. The two groups were intervened for 12 weeks each time, and obesity evaluation indicators such as body weight, body fat, waist circumference, hip circumference, weight index, and score table of TCM constitutional were observed before and after the intervention. Statistical software was used for statistical analysis. RESULTS: The total curative effect of the treatment group was better than that of the control group(P<0.001). The weight index, body weight, waist and hip circumference decreased significantly after treatment(P <0.01). Compared with the two groups, the treatment group is better than the control group in terms of dampness constitution improvement, weight and fat losing and waist and hip circumference reducing.(P<0.01). CONCLUSION: Oral Chinese medicine granules Jiangzhuo Fang(combined with health education) and simple health education can improve phlegm constitution, and improve the body weight, body fat percentage and other indicators of the patients, but oral granules combined with health education to improve the physical fitness of phlegm is better than simple health education. The thoughts and methods of Chinese medicine granules combined with health education to regulate phlegm constitution is effective for weight losing and is worthy of further research and promotion.

Chinese patent medicine for chronic obstructive pulmonary disease based on principles of tonifying Qi, promoting blood circulation by removing blood stasis, and resolving phlegm: a systematic review of randomized controlled trials

OBJECTIVE: To assess the efficacy and safety of Chinese patent medicine(CPM) with the principle of tonifying Qi, promoting blood circulation by removing blood stasis, and resolving phlegm(TQ-PBC-RP)in the management of stable chronic obstructive pulmonary disease(COPD).METHODS: A systematic review of randomized controlled trials(RCTs) identified from electronic databases and print was conducted. RCTs testing CPMs with TQ-PBC-RP against any type of controlled intervention in patients with stable COPD and assessing clinically relevant outcomes were included. Methodological quality was evaluated with the risk of bias tool according to systematic review handbook 5.0.2. Quality of evidence was estimatedby the rating approach developed by the Grading of Recommendations, Assessment, Development,and Evaluation Working Group.RESULTS: Thirteen eligible RCTs with 12 oral CPMs were tested. Significant differences between groups in favor of CPMs were not reported in all trials. Most trials included were deemed to be of low methodological quality with poor evidence quality.Because of large data heterogeneity, statistical pooling was not performed for all outcomes.CONCLUSION: The effectiveness of CPM in the treatment of stable COPD is not supported by evidence. Currently, evidence from RCTs is scarce and methodologically weak. Considering the popularity of CPMs among patients undergoing COPD, rigorously designed trials are warranted.

Therapeutic Effect of Chinese Herbal Medicine for Strengthening Qi,Nourishing Yin,and Removing Stasis on Serum Osteopontin and Quality of Life of Patients with Primary Sjogren's Syndrome

Objective：To observe the therapeutic effect of Chinese herbal medicine for strengthening qi, nourishing yin,and removing stasis on serum osteopontin（OPN） and quality of life（QOL） in patients with primary Sjogren＇s syndrome（pSS） and to study the correlation between OPN level and the disease.Methods：Sixtyeight pSS patients were randomly assigned to two groups：the treatment group（35 cases） treated by Chinese herbal medicine for strengthening qi,nourishing yin,and removing stasis combined with hydroxychloroquine sulfate tablet（HCQ） and the control group（33 cases） treated by HCQ only.Both were treated for 3 months. Before and after treatment,immunoglobulin G（IgG） level,erythrocyte sedimentation rate（ESR）,and OPN level were measured.The QOL in patients was evaluated using the Short Form-36 Health Survey（SF-36） before and after treatment.Thirty healthy females were taken as the normal control.Results：Before treatment,levels of IgG,ESR,and OPN in patients were higher than those in the normal control.After 3 months of treatment, those in both treatment groups decreased but were lower in the treatment group than those in the control group （P0.05）.The scores of 8 dimensions of SF-36 were lower in the pSS patients than those in the normal control （P0.05） and higher in the treatment group than in the control group after treatment（P0.05）.Furthermore, there was a positive correlation between the levels of OPN and the levels of IgG and ESR,and a negative correlation between OPN levels and the overall score of SF-36（P0.05）.Conclusions：Chinese herbal medicine for strengthening qi,nourishing yin,and removing stasis could alleviate pSS disease and improve the QOL.In addition,the OPN level might be used as an evaluating index for pSS disease.

Research Progress in Chinese Medicine Preparations for Promoting Blood Circulation and Removing Blood Stasis for Cirrhotic Patients with Portal Vein Thrombosis Following Splenectomy

This article presented an overview of the therapeutic effects of Chinese medicine(CM)preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis(PVT)after splenectomy.Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension(CPH),this paper evaluated the incidence of PVT,and explored potential active components and mechanisms of CM preparations.Safflower Yellow Injection,Danshen Injection,Danhong Injection,and Compound Danshen Dropping Pill achieved good curative effect alone or combined with anticoagulant therapy.In addition,Compound Biejia Ruangan Tablet and Anluo Huaxian Pill can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis.Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH,we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.

Potential advantages of a combination of Chinese Medicine and bone marrow mesenchymal stem cell transplantation for removing blood stasis and stimulating neogenesis during ischemic stroke treatment

Combined treatment of ischemic stroke with Chinese medicine and exogenous bone marrow mesenchymal stem cell(BMSC) transplantation may improve the removal of blood stasis and stimulation of neogenesis.Chinese medicines that remove blood stasis not only promote blood circulation but also calm the endopathic wind,remove heat,resolve phlegm,remove toxic substances and strengthen body resistance.The medicinal targeting effect of Chinese medicine can promote the homing of BMSCs,and the synergistic therapeutic effects of drugs can contribute to BMSC differentiation.As such,exogenous BMSC transplantation has potential advantages for neogenesis.Chinese medicines and exogenous BMSCs provide complementary functions for the removal of blood stasis and stimulation of neogenesis.Therefore,a combination of Chinese medicine and transplantation of exogenous BMSCs may be particularly suited to ischemic stroke treatment.

Key to Treating COVID-19: Removing Phlegm from Small Airways

According to autopsy reports,patients who died from COVID-19 had a lot of mucus in the lung that obstructed the airways,reduced the effect of mechanical ventilation,and even led to pulmonary failure.Traditional Chinese medicine literature mentions that"Inability to remove phlegm impair s the lung,which leads to death."Hence one of the most urgent problems to be solved is to remove phlegm from the small airways.This article elaborates ten methods to remove phlegm for clinical reference.

Key to Treating COVID‑19:Removing Phlegm from Small Airways

According to autopsy reports,patients who died from COVID‑19 had a lot of mucus in the lung that obstructed the airways,reduced the effect of mechanical ventilation,and even led to pulmonary failure.Traditional Chinese medicine literature mentions that“Inability to remove phlegm impairs the lung,which leads to death.”Hence one of the most urgent problems to be solved is to remove phlegm from the small airways.This article elaborates ten methods to remove phlegm for clinical reference.

Diagnostic value of traditional Chinese medical dialectical classification in hashimoto's thyroiditis complicated with suspicious nodules

Objective:To explore the diagnostic value of traditional Chinese medical(TCM)dialectical classification in Hashimoto's thyroiditis complicated with suspicious nodules.Methods:The clinical data of patients with Hashimoto's thyroiditis complicated with thyroid nodules in the Department of Breast and thyroid surgery of Weifang Hospital of traditional Chinese Medicine from January 2018 to December 2019 were collected.The patients were examined by 2 or more experienced TCM doctors,and the four diagnostic data were obtained,and then the relevant syndrome types of the patients were judged according to the data.According to the color Doppler ultrasonographic features of thyroid nodules,the patients who met the indication of fine needle aspiration biopsy of thyroid nodules were selected and underwent fine needle aspiration biopsy of thyroid nodules before operation.To analyze the clinical diagnostic value of that the ultrasonic mode used in this study and thyroid cytopathology Bethesda report system combine dialectical classification of traditional Chinese medicine in Hashimoto's thyroiditis complicated with suspected thyroid nodules.Result:A total of 89 patients with Hashimoto's thyroiditis complicated with thyroid nodules were collected.according to the ultrasonic mode,the difference between different modes was statistically significant(P<0.05).The mode of color ultrasound is also related to the dialectical classification of traditional Chinese medicine.The patients with high malignant risk score are mainly qi depression and phlegm stagnation,phlegm and blood stasis,while those with low score are exuberant liver fire and heart liver yin deficiency.According to the study of different The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC)classification,the dialectical classification of patients with higher TBSRTC classification was more inclined to qi depression and phlegm stagnation,phlegm and blood stasis,and there was significant difference between different classification(P<0.05).Conclusion:Qi depression and phlegm obstruction,phlegm and blood stasis have high ultrasound malignant risk score and high TBSRTC classification grade in patients with Hashimoto's thyroiditis complicated with suspected thyroid nodules,which has important clinical diagnostic value.

补肾活血方治疗肾虚血瘀型卵巢储备功能下降患者的临床疗效观察

目的观察补肾活血方对肾虚血瘀型卵巢储备功能下降(DOR)患者的治疗效果。方法选取北京妇产医院中医科2021年1月至2022年12月就诊的180例诊断为DOR的肾虚血瘀型患者作为研究对象,采用计算机随机分组法分为雌二醇片/雌二醇地屈孕酮片组(西药组)、补肾活血方组(中药组)和补肾活血方联合雌二醇片/雌二醇地屈孕酮片组(联合组),各60例。观察三组治疗前后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、抗米勒管激素(AMH)、窦卵泡数(AFC)、卵巢体积、卵巢动脉和子宫动脉阻力指数(RI)、子宫内膜厚度的变化,比较三组中医证候评分及疗效。结果11例患者(4例来自西药组,3例来自中药组,4例来自联合组)退出研究。6个月后,三组FSH和LH均显著降低,E_(2)和AMH升高(P<0.05);西药组和联合组较中药组FSH降低更显著,E_(2)升高更显著(P<0.01)。治疗后,中药组和联合组卵巢体积增加(P<0.05),AFC显著增加(P<0.01),卵巢动脉RI显著降低(P<0.01);西药组卵巢体积增加不显著(P>0.05),AFC显著增加(P<0.05),卵巢动脉RI显著降低(P<0.05);三组子宫动脉RI均无显著改善(P>0.05)。三组子宫内膜厚度均显著增加(P<0.05),西药组和联合组较中药组增加更显著(P<0.01)。与治疗前相比,三组治疗后中医证候评分均显著降低(P<0.05),且中药组和联合组中医证候评分降低的程度大于西药组(P<0.05)。西药组总有效率为71.43%,中药组为82.46%,联合组为85.96%;联合组的疗效优于西药组(P<0.05)。结论补肾活血方能够通过平衡激素水平、促进排卵和修复子宫内膜对DOR患者产生良好的治疗效果,联合应用雌二醇片/雌二醇地屈孕酮片可能是治疗DOR的一种行之有效的治疗策略。

化瘀丸治疗中晚期恶性肿瘤患者血液高凝状态的临床研究

目的:探讨化瘀丸治疗中晚期恶性肿瘤患者血液高凝状态的临床疗效和安全性。方法:选取2018年6月至2021年12月北京中医医院肿瘤科门诊和病房的中晚期恶性肿瘤血液高凝状态患者72例作为研究对象。采用前瞻性队列研究,根据是否应用化瘀丸分为观察组(n=35)和对照组(n=37)。对照组接受必要的物理对症支持治疗,观察组在对照组基础上口服化瘀丸8周,2组共随访24周。观察2组患者的血液高凝状态改善率、凝血指标变化、中医证候积分、静脉血栓栓塞(VTE)大出血发生,以及不良事件发生情况。结果:4周后,观察组血液高凝状态改善率为43.75%,对照组为29.41%(P>0.05);8周后,观察组血液高凝状态改善率为65.63%,对照组为41.18%(P<0.05)。进一步分析凝血相关指标变化,发现4周和8周后观察组血浆纤维蛋白原(FIB)低于对照组(P<0.05)。观察组患者中医证候积分改善的总有效率为50.00%,对照组为14.81%(P<0.05),2组患者均未出现大出血情况,观察组未发生药物相关不良事件。结论:化瘀丸可以在必要的物理支持治疗外,进一步改善中晚期恶性肿瘤患者血液高凝状态,缓解血瘀证相关症状。