Core outcome set for stable angina pectoris in traditional Chinese medicine(COS-SAP-TCM)

Objective:This study aimed to develop a core outcome set(COS)for use in future studies of stable angina pectoris(SAP)in traditional Chinese medicine(TCM).Methods:Systematic literature reviews and qualitative interviews with cardiologists and patients with SAP treated using TCM were conducted to generate a set of outcomes.Outcomes were prioritized by stakeholders via two rounds of an online Delphi survey and face-to-face consensus meetings.Following the final consensus meeting,a final COS was generated.Results:An initial set of 324 outcomes was identified.A preliminary list of 65 outcomes was employed in the Delphi study.In total,223 participants from seven stakeholder groups were invited to score outcomes in the first Delphi round:87 completed round 1 and 47 completed round 2.Thirty-one participants attended the consensus meeting and agreed on a final core set of outcomes comprising six items across four domains:frequency of angina attack,duration of angina attack,Seattle angina questionnaire,total exercise duration in the exercise treadmill test,cardiovascular events,and QT interval on electrocardiography.Conclusions:The COS developed in this study provides the minimum requirements for measurement and reporting in future TCM clinical trials for the treatment of SAP.The employment of this COS may reduce heterogeneity across trials and facilitate evidencebased decision-making for stakeholders.

Status of Clinical Application of Yufeng Ningxin Preparations and the Meta-Analysis of Its Efficacy and Safety in the Treatment of Cardiovascular and Cerebrovascular Diseases

Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular and cerebrovascular diseases.Methods Through searching databases of China National Knowledge Infrastructure,Wanfang,SinoMed,VIP,PubMed,Embase,and the Cochrane Library,the literature of clinical research on YFNX preparations in treating malignant tumors of cardiovascular and cerebrovascular diseases from the establishment of the databases to February 2021 was collected.The clinical randomized controlled trials and case-control studies of cardiovascular and cerebrovascular diseases treated with these preparations were analyzed.Two reviewers independently screened literature,extracted data,and assessed the risk of bias in the included studies,and meta analysis was performed by using ReMan 5.3 software to analyze the eficacy and safety of YFNX preparations in the treatment of cardiovascular and cerebrovascular diseases.Results A total of 29 clinical studies were finally included.The dosage forms were dropping plls,tablets,capsules,and granules.The preparations were used for the treatment of coronary heart disease,hypertension,neuropathic headache,etc.This study systematically evaluated the efficacy and safety of YFNX preparations in the treatment of coronary heart disease,hypertension,and nervous headache.A total of 1,162 cases were included in 13 studies,582 cases of the YFNX preparation group and 580 cases of the Western medicine group.The results of meta-analysis showed that the clinical efficacy of YFNX preparations combined with the Western medicine group in the treatment of coronary heart disease and hypertension,improving electrocardiogram and reducing the frequency and duration of angina attacks,was better than that of the simple Western medicine group,and the difference was statistically significant.Conclusion YFNX preparations are effective for coronary heart disease,hypertension,and neuropathic headache,and the adverse reactions are few.

药食同源 生姜妙用

中医自古认为药食同源,姜是最好的范例之一。生姜可以拿来炒菜、调味、去腥,是日常生活中的常见食材。着凉感冒时,一杯热姜水便能迅速促进发汗,将鼻塞头痛等不适症状一扫而空,是民间治疗风寒感冒的常用小妙招。《本草经疏》对生姜记载:“辛可散邪理结,温可除寒通气,温中出汗,逐风湿痹。”而中医认为外界的风寒湿邪正是关节类疾病主要病因,由此可见,生姜还可以治疗风湿性关节炎。同时科学研究发现,生姜的主要活性成分姜酚具有良好的抗风湿、调节免疫和抗炎作用,能够缓解关节疼痛。

A network pharmacological study to investigate the combination of LHQW-XYS in the treatment of COVID-19 olfactory impairment-associated

To explore the target of action of LHQW-XYS on the main components of COVID-19 olfactory impairment by using network pharmacological methods and try to reveal its mechanism of action in the treatment related to COVID-19 induced olfactory impairment,we used the TCMSP platform to obtain potential active ingredients through oral utilization and drug-like properties screening;the Swiss TargetPrediction platform to predict the targets of the active ingredients and construct a drug-ingredient-target network,and then obtained the gene targets of COVID-19 olfactory injury through GeneCards,OMIM,and TTD platforms to intersect the drug targets and disease genes to obtain common targets.The drug targets and disease genes were intersected to obtain common targets.STRING and Cytoscape 3.8.2 software were used to construct the target-disease gene PPI network,screen the key targets and core gene clusters,and analyze the key targets by GO and KEGG enrichment analyses with the help of the Metascape platform,and then map the screened core active ingredients and their targets into the pathway to construct the core active ingredients-targets-pathway network.The core active ingredient-target-pathway network was constructed,and finally,molecular docking was carried out.The results showed that there were 4669 potential targets,5609 disease targets,and 17 drug-disease cross-targets for the active ingredients of LHQW-XYS.The GO and KEGG enrichment analyses indicated that the mechanism of LHQW-XYS in the treatment of olfactory impairment in COVID-19 may be due to the regulation of related signaling pathways,such as Serotonergic synapse and Regulation of lipolysis in adipocytes.Molecular docking showed that six active components(quercetin,luteolin,kaempferol,7-methoxy-2-methylisoflavone,wogonin,medicarpin)and two key genes(PTGS2,PPARG)had good binding properties.In the end,we conclude that LHQW-XYS may act on Serotonergic synapse and Regulation of lipolysis in adipocyte pathways to achieve anti-COVID-19 olfactory impairment-associated effects.

Study of the relationship between acupuncture dose and effect

Acupuncture dose-effect relationship is the essential feature of acupuncture and the key factor of acupuncture’s therapeutic effect.It is a comprehensive category,including needle direction,needle strength,needle depth,selection of specific techniques,length of time between acupuncture treatment sessions,length of needle retention time,and frequency of treatment,all of which play a decisive role in the curative effect and prognosis of diseases[1].

How to conduct an acupuncture dose–effect relationship study? A discussion based on study methodology

Acupuncture therapy is widely used in the clinic,and its therapeutic effects have been proven by numerous studies.The dose–effect relationship of acupuncture is a fundamental aspect of the acupuncture research system.Recent studies found that different acupuncture dosages altered study results directly,indicating the importance of screening the optimal stimulation dosage.However,the system for studying the acupuncture dose–effect relationship is still in its infancy,and the methodology of the system needs to be improved.This review aimed to define the factors impacting acupuncture“dosage”and“effect,”and to improve the methodological system for research on the dose–effect relationship of acupuncture.By summarizing the current findings of acupuncture dose–effect studies,we discussed the vital acupuncture parameters and methodological problems that influence the relationship between acupuncture dosage and its effects.These factors consist of specific influencing factors(acupoint selection,acupuncture manipulation parameters,de qi response)and nonspecific influencing factors(comparison selection,blinding procedure,patient expectancy).Our perspectives offer suggestions for the design of acupuncture dosage–effect trials.Further studies need to be conducted to establish the methodological system and provide systematic evidence of the acupuncture dose–effect relationship.

Study on timing and dosage of acupuncture in stroke treatment

Objective： To summarize the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture in stroke treatment. Method： Literature research was conducted for quantitative clinical studies of acupuncture in stroke treatment, with the entry point on the timing factor and dosage factor. A hierarchical analysis was performed on observing the time–efficacy relationship and the dosage–efficacy relationship before, during and after acupuncture. Results： Though the retrieved studies differ especially in such timing factors as needle retaining time, acupuncture interval and course, they share an agreement in the acupuncture intervention time point, acupuncture timing, specificity of acupoints and acupuncture manipulation. Conclusion： The optimal stimulation is the core of the research on the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture and also the key to the clinical efficacy.

Effect of holistic stratification acupotomy on lower limb function,MMP1 and MMP13 in bursal fluid of patients with knee osteoarthritis:A randomized clinical trail

Objective:To observe the differences in clinical effect on knee osteoarthritis(KOA)between the holistic stratification acupotomy and the joint injection with sodium hyaluronate so as to provide a safe and effective treatment for KOA.Methods:A total of 100 KOA patients were randomly divided into an acupotomy group and a sodium hyaluronate group,50 patients in each one.In the acupotomy group,the holistic stratification acupotomy was adopted.In the sodium hyaluronate group,sodium hyaluronate injection was applied in the joints.The index of Western Ontario and McMaster University(WOMAC)and the expressions of MMP1 and MMP13 in bursal fluid of the patients were compared before and after treatment in the patients between two groups before and after treatment,and the clinical therapeutic effect was observed.Results:After treatment,WOMAC score of each dimension and the concentrations of MMP1 and MMP13 in bursal fluid of the patients of either group were all lower than those before treatment(all P<0.05).After treatment,WOMAC score of each dimension and the concentrations of MMP1 and MMP13 in bursal fluid in the acupotomy group were lower than the sodium hyaluronate group(all P<0.05).The total effective rate in the acupotomy group was higher than that of the sodium hyaluronate group(P<0.05).Conclusion:Both the holistic stratification acupotomy and the joint injection with sodium hyaluronate are effective on KOA in this trial.However,the therapeutic effect of holistic stratification acupotomy is remarkable,which is probably related to the improvements in inflammatory response.

The analgesic effect of electroacupuncture in complete Freund's adjuvant rats:a meta analysis

Pain is a global problem and has been found sensitive to acupuncture. A large number of existing and newly published studies have demonstrated the analgesic effect of electroacupuncture(EA) in complete Freund's adjuvant(CFA) rat model, necessitating a new and comprehensive review. To evaluate the curative effect of EA on thermal hyperalgesia in CFA rats, and to explore parameters that influence treatment effects, studies of EA treatment on thermal hyperalgesia of CFA rat model were identified from nine databases up to June 17, 2017. Outcome measure was heat pain threshold. All the data were analyzed using Stata 14.0/MP software. 26 studies identified included 801 rats. The quality score of the studies ranged from 3 to 6, with a mean of 4.08. The effect of EA group was improvement in outcome compared with CFA group. In subgroup analyses, frequency 2, 100, 2/100 or 20-100 Hz. acupoint Huántiào(环跳GB30),Kūnlún(昆仑 BL60) +Xuánzhōng(悬钟 GB39), Zúsānlī(足三里 ST36) +BL60 or ST36+Sānyīnjiāo(三阴交SP6), retention time 20 or 30 min, treatment time for post-CFA injection immediately, the same day as CFA injection, post-CFA injection 24 or 48 h and interval 24 or 48 h all can improve the effect on CFA rat heat pain threshold. These results show that there is positive effective of EA in CFA-induced pain,different parameters have different effects on EA treatment of CFA heat hyperalgesia, however, because of the number of eligible researches and the high risk of bias, the evidence supporting this conclusion is limited.