Action mechanisms of complementary and alternative medicine therapies for rheumatoid arthritis

Rheumatoid arthritis(RA) is characterized as a chronic inflammatory disease in joints and concomitant destruction of cartilage and bone.Cartilage extracellular matrix components,such as typeⅡcollagen and aggrecan are enzymatically degraded by matrix metalloproteinases(MMPs) and aggrecanases in RA.Currently,treatments targeting cytokines,including anti-tumor necrosis factor (TNF)αantibodies,soluble TNF receptor,anti-interleukin(IL)-6 receptor antibody, and IL-1 receptor antagonist,are widely used for treating RA in addition to anti-inflammatory agents and disease-modifying antirheumatic drugs(DMARDs),such as methotrexate,but these treatments have some problems,especially in terms of cost and the increased susceptibility of patients to infection in addition to the existence of low-responders to these treatments.Therefore,therapeutics that can be safely used for an extended period of time would be preferable.Complementary and alternative medicines including traditional Chinese medicines(TCM) have been used for the arthritic diseases through the ages.Recently,there are many reports concerning the anti-arthritic action mechanisms of TCM-based herbal formulas and crude herbal extracts or isolated ingredients.These natural herbal medicines are thought to moderately improve RA,but they exert various actions for the treatment of RA.In this review,the current status of the mechanism exploration of natural compounds and TCM-based herbal formulas are summarized,focusing on the protection of cartilage destruction in arthritic diseases including RA and osteoarthritis.     

The add-on effect of a Chinese herbal formula for patients with resistant hypertension:study protocol for a pilot cohort study

BACKGROUND: Despite a recent American Heart Association(AHA) consensus statement emphasizing the importance of resistant hypertension(RH), its control is still a challenge for conventional medicine. The Chinese herbal formula, Qutan Huayu Fang, has been used effectively to assist antihypertensive agents in blood pressure control, but its effect for RH patients is still unclear. This pilot study aims to explore the effects of taking the formula in addition to antihypertensive medication in the management of RH.METHODS/DESIGN: A prospective cohort study will be conducted in two first-class hospitals of traditional Chinese medicine(TCM). Eligible RH patients will be classified as the experimental group(n = 100) and the control group(n = 100) based on the interventions they receive. Participants taking antihypertensive agents and the Chinese herbal formula will be in the experimental group and those taking antihypertensive agents alone will be in the control group. The whole study will last 24 weeks, including an 8-week observation and follow-up at 24 weeks. The primary outcomes, assessed against patient baseline conditions, will be the reduction of systolic blood pressure and diastolic blood pressure as well as changes in TCM symptoms and signs. These outcomes will be assessed at weeks 2, 4, 6, and 8. The reductions of blood pressure will also be assessed at week 24. Cardiac events and mortality rate will be secondary outcomes and will be assessed at weeks 8 and 24. Any adverse reactions will be recorded during the study. The causal inference method will be used to assess the effectiveness of the inclusion of TCM herbal medicine in the management of patients with RH.DISCUSSION: This study will determine whether the Chinese herbal formula is helpful for RH patients treated with antihypertensive agents and the findings will provide a basis for further confirmatory studies.     

Chinese herbal medicine Xinfeng Capsule in treatment of rheumatoid arthritis： study protocol of a multicenter randomized controlled trial

BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA. METHODS AND DESIGN： This is a 12-week, randomized, placebo-controlled, double-blind, multicenter trial on the treatment of RA. The participants will be randomly assigned to the experimental group and the control group at a ratio of 1：1. Participants in the experimental group will receive Xinfeng Capsule and a pharmaceutical placebo （imitation leflunomide）. The control group will receive leflunomide and an herbal placebo （imitation Xinfeng Capsule）. The American College of Rheumatology （ACR） Criteria for RA will be used to measure the efficacy of the Xinfeng Capsule. The primary outcome measure will be the percentage of study participants who achieve an ACR 20% response rate （ACR20）, which will be measured every 4 weeks after randomization. Secondary outcomes will include the ACR50 and ACR70 responses, the side effects of the medications, the Disease Activity Score 28, RA biomarkers, quality of life, and X-rays of the hands and wrists. The first four of the secondary outcomes will be measured every 4 weeks and the others will be measured at baseline and after 12 weeks of treatment. DISCUSSION： The result of this trial will help to evaluate whether Xinfeng Capsule is effective and safe in the treatment of RA. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is N CT01774877.     

Relationship Between Traditional Chinese Medicine(TCM) Constitution and TCM Syndrome in the Diagnosis and Treatment of Chronic Diseases

Chronic diseases are global threats to human health. By applying the traditional Chinese medicine (TCM) theory of body constitution to the treatment of chronic diseases, and comprehensively identifying and differentiating the syndrome, disease, and constitution, TCM can be fully used in the diagnosis and treatment of chronic diseases. In this manner, population-based and evidence-based modern medicine can organically align with the individual-focused and speculation-based TCM, with subsequent benefits for the control of chronic diseases, reducing their burden on human health.     

Chinese Medicine,Which Targets Body's Response State,Is An Effective Way to Treat Epidemic Infectious Diseases

In the fight against epidemic infectious diseases in the past 2,000 years,Chinese medicine(CM)has gradually developed a complete response system including diagnosis and treatment.The focal point of CM in the treatment of infectious diseases is the personalized response state to pathogen,which is a treatment method consistent with the personalized concept of precision medicine.Compared with the methods of directly killing or inactivating pathogens,which are used in modern medicine,CM is an effective treatment modality that has a wider range of points of action in the human body.The remarkable effects achieved while treating SARS in 2003 and the current coronavirus disease 2019(COVID-19)pneumonia and the history of the effective responses to epidemics in the past 2,000 years have fully demonstrated the effectiveness of CM in treating infectious diseases.This article discusses the different treatment mechanisms for infectious diseases in CM and modern medicine and the advantages of CM methods,which will reacquaint the world with CM.The improvement of the diagnosis and treatment system of CM based on scientific concepts and methods and the organic combination of both treatment methods of modern medicine and CM will provide the best solution for humans to defeat epidemic infectious diseases.     

Progress of research in treatment of hyperlipidemia by monomer or compound recipe of Chinese herbal medicine

Hyperlipidemia （HLP） is the No.1 risk factor for patients with atherosclerosis （AS） and is directly related to the occurrence of coronary artery disease （CAD） and cerebrovascular disease. Therefore, prevention and treatment of AS is of great importance and of practical significance in controlling the incidence and mortality of CAD. With its peculiar syndrome-dependent therapy, traditional Chinese medicine （TCM） has accumulated abundant practical experiences in this field and good clinical effects have been achieved. Chinese herbal medicine, with its particularly unique advantages and high potentials yet to be tapped, displays its huge strength in HLP prevention and treatment. The progress of studies concerning prevention and treatment of HLP by Chinese herbal medicines, in the form of monomers or compound recipes, is reviewed in this paper.     

Treatment of Functional Dyspepsia by Alternative Medicine in China

Functional dyspepsia （FD） is of high morbidity. It is categorized into 3 subgroups and generally is treated with respective agents. However, Chinese specialists in Alternative Medicine-mainly in Traditional Chinese Medicine （TCM） - have been researching its diagnosis, therapeutics and mechanisms and have got remarkable achievements for these years. In those achievements, FD has been considered to refer to 2 TCM disorders （＇stuffy and full sensation＇ and ＇stomach pain＇） and differentiated into 5 syndromes： （1） liver depression and Qi stagnation syndrome, （2） liver depression and spleen asthenia syndrome, （3） spleen asthenia accompanying phlegm and dampness syndrome, （4） accumulation and stagnation of indigestive food syndrome, and （5） co-existence of cold and heat syndrome. Besides, researchers have studied the relationships among those syndromes and between the Chinese medical syndromes and some physiological and biochemical variations. Clinically, China Association of Chinese Medicine has established the Diagnostic and Therapeutic Criteria of TCM for Functional Dyspepsia and the therapists have been evaluating the effect of treating FD with Chinese herbal medicine, acupuncture and massage. Researchers have also been studying the mechanisms of those therapies and have made some encouraging progress. It can be concluded that those therapies have a significant effective rate in treating FD, although without enough evidence-based clinical and experimental designs. And despite being independent of modern science, the traditional theories show some relations with conventional western medicine, and those achievements can enlighten the researchers in the fields.     

Research on frequency of application with modern Chinese herbal medicine

Objective:To study the relationship between 500 kinds of commonly used Chinese herbal medicine and the classification of their efficacies in Chinese Materia Medica in relation to the common diseases listed in Internal Medicine.Methods:Database retrieval frequency of the quantitative statistical method was adopted.First,the 8 980 kinds of Chinese herbal medicine recorded in Chinese Materia Medica were used as the original search objects,and 4 493 kinds which were cited in more than five articles were picked out and then rechecked for further title citations.Second,as judged based on the Criterion,the numbers of articles which included the medicines in the line of standards were examined.As a result,500 species of Chinese herbal medicine were singled out based on their retrieval frequency and were then used for compilation of the classification statistics according to their efficacy and the common diseases in Internal Medicine.Results:From the classification of Chinese medicines,herbs with wide efficiency and a meek nature had higher frequencies, but those which were not appropriate as decoctions had relatively lower frequencies.However,according to the average frequency,the Chinese herbal medicine for nourishing qi and tonifying blood,at 36 346 times and 34 544 times,respectively,were the most commonly used.Analyzed from the frequency of application of the Chinese medicine in the treatment of common diseases,most of the top 10 kinds of Chinese herbal medicine with the highest frequencies generally coincided with the 500 selected medicines.In addition,the Chinese medicines with clear pharmacological efficiency were easily isolated and purified to be made into injections, although other forms are more commonly used.Conclusion:The results of the research objectively reflected the current applications of Chinese herbal medicine,and could be used as references in teaching,research,clinical applications,and in compiling and increasing the drugs in textbooks and Pharmacopoeia.     

Progress of Integrative Chinese and Western Medicine in Treating Polycystic Ovarian Syndrome Caused Infertility

Polycystic ovarian syndrome （PCOS） is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine （ICWM）. It can be seen from these materials that using traditional Chinese medicine （TCM） recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.     

The Western model of integrative oncology — the contribution of Chinese medicine

<正>Western integrative oncology(IO) combines conventional mainstream medicine with complementary and alternative medicine(CAM) for the care of cancer patients.Since it includes patient orientation and the holistic approach of many CAM options,IO offers not only preventive measures,but also a wide spectrum of treatment modalities for all stages of illness,from the acute phases through the rehabilitation period.Many therapeutic methods of IO are supported by scientific evidence,for example,dietary and nutritional counseling,exercise,and mind-body medicine,among others.IO also includes therapeutic interventions of traditional Chinese medicine(TCM).At present acupuncture,qigong,and foot massage play an important role in the Western care of cancer patients.However,unlike in China, in Western countries herbal remedies are usually only used during those periods in which chemotherapy is not applied in order to avoid herb-drug interactions.Instead, acupuncture is widely used to manage the side-effects that often accompany chemotherapy.This paper focuses on the role of Chinese medicine in Western IO and reviews the scope and limitations of IO in the care of cancer patients today.The future challenges of IO will also be discussed in this paper.     

RELIEVING CANCEROUS PAIN AND IMPROVING THE SURVIVAL QUALITY WITH FEI AI CHONG JI

Fei Ai Chong Ji is a pure herbal prepa-ration to be taken after being infused in hotwater for the treatment of lung cancer. Thedevelopment of the preparation is based onthe TCM principle of strengthening thebody resistance to eliminate pathogenic fac-tors and combining differentiation of symp-toms with discrimination of diseases. In re-     

Effects and mechanisms of actions of Chinese herbal medicines for asthma

Asthma is a chronic inflammatory disorder of airways that affects approximately 300 million adults and children worldwide.Most therapy currently uses bronchodilators and corticosteroids.Systemic side effects from chronic use of these drugs are concern.Chinese medicine(CM)has a long history of human use in China and other Asian countries and well received by the patients.But as one component of Western integrative medicine(WIM),it is required that CM use is supported by scientific evidence.On the other hand,there are also suggestions that Western standardized medicine should consider personalized practice.In recent years there have been an increasing studies to narrow the gap between CM,the personalized medicine and Western medicine,evidence based medicine.This communication reviews several CM studies published in the English language in details by reviewing the effects and mechanisms of actions on asthma from clinic and experimental studies. Chinese herbal medicines exhibit broad actions on multiple asthma pathologic mechanisms.These mechanisms may involve antiinflammatory and immunomodulatory effects,inhibiting airway remodeling and normalization of hypothalamus,pituitary and adrenal(HPA)-axis disturbances.However,the mechanisms of actions of Chinese herbal medicines for asthma are not fully understood.More controlled clinical studies are warranted and some anti-asthma CM may be proved to be effective when used as monotherapy or complementary asthma therapies.     

The Neuropharmacological Effects of Herba Epimedii and its Main Bioactive Components：Icariin， Icariside Ⅱ and Icartin

Herba Epimedii,a traditional & Chinese medicine （T&CM）,is used as a tonic, remedy for calming the nerves and anti-rheumatic agent in some Chinese proprietary medicine. Icariin,icarisideⅡ and icartin,are main bioactive products present in this herb. Previous studies have demonstrated that these compounds possess broad therapeutic capabilities,especially anti-osteoporosis, anti-oxidative stress and anti-cancer effects. In recent years,growing numbers of researches have focused on pharmacological actions of Herba Epimedii in central nervous system. Numerous preclinical studies have demonstrated that Herba Epimedii as agent for neurological disease,and our reports showed powerful neruoprotective effects of icariin and icarisideⅡ in Alzheimer’s disease （AD） and ischemic brain injury. Mechanistically,icariin increased cerebral blood flow and amyloid β-protein （Aβ） clearance,enhanced neurogenesis and memory,promoted synaptic plasticity may through the PDE5/NO/cGMP signaling pathway. Moreover,icariin is also effi cient at anti-depression,and possible molecular mechanisms involve in decrease of the hyper-responsiveness of corticotropin-releasing factor （CRF）,regulation of 5-hydroxytryptamine system and anti-infl ammation effect. Although some Chinese proprietary medicine which are contain icariin have been used for osteoporosis in clinic,but no agents for neurological diseases. To further promote the researches on prevention and treatment of Herba Epimedii on central nervous system diseases,this review aim to summarize the anti-AD,anti-aging,and anti-ischemic brain injury effects of compounds of Herba Epimedii with reference to publisheddata. Base on the literature compiled,the compounds of Herba Epimedii have tremendous potential to be developed therapeutic drugs for AD,ischemic stroke and depression. It is our hope that traditional Chinese medicine health industry could promote the development of health and contribute to the health welfare for all.     

STUDIES ON THE REVERSIBILITY OF INFERTILITY CAUSED BY LONG TERM ADMINISTRATION OF TRIPTERYGIUM HYPOGLAUCUM IN MALE RATS

An alcoholic extract of the root of Triptcrygium hypoglaucum (ATFI) is a Chinese herbal medicine, available in the market as tabtcts, used for the treatment of rheumatoid arthritis and some skin diseases. ATH had bccn shown to cause infertility in male     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：病因部分（一）

In traditional Chinese medicine （TCM）, the causes of diseases are generally divided into three categories, i.e. internal cause, external cause and the cause that is neither internal nor external, related to the aspects of the so-called six excesses （六淫）, seven emotions （七情） and intemperance of food （饮食不节）. Since diseases are different, the causes are undoubtedly various. To describe these unique causes, some special terms, phrases and expressions have been used in TCM, which, on the surface, are quite easy to understand, but in fact, bear profound cultural and medical significance.     

Adenoviral transduction of PTEN induces apoptosis of cultured hepatic stellate cells

Hepatic fibrosis is the liver＇s wound healing response to virtually all forms of chronic liver injury： toxic insult, viral infection, immunological conditions and metabolic diseases. Uncontrolled liver fibrosis eventually results in cirrhosis and associated complications, such as cancer and liver failure. Given the enormous public health implications, recent improvements in the treatment of chronic liver disease have accelerated interest in uncovering the mechanisms underlying hepatic fibrosis and its resolution. Currently, it is believed that activation of quiescent hepatic stellate cells （HSC） into proliferative, contractile, and fibrogenic cells in response to liver injury appears to be the dominant driving force in fibrosis.     

Clinical Application of the TCM Classic Formulae for Treating Chronic Bronchitis

The principle of formulae corresponding to syndromes is an unique model described in the classics of traditional Chinese medicine (TCM) for treatment of diseases. Making the symptoms and signs as the therapeutic targets, in which the intuitive judgments and jumping characteristics are manifested.1-3     

Immune Homeostasis: Effects of Chinese Herbal Formulae and Herb-Derived Compounds on Allergic Asthma in Different Experimental Models

Allergic asthma is thought to arise from an imbalance of immune regulation, which is characterized by the production of large quantities of Ig E antibodies by B cells and a decrease of the interferon-γ/interleukin-4(Th1/Th2) ratio. Certain immunomodulatory components and Chinese herbal formulae have been used in traditional herbal medicine for thousands of years. However, there are few studies performing evidence-based Chinese medicine(CM) research on the mechanisms and efficacy of these drugs in allergic asthma. This review aims to explore the roles of Chinese herbal formulae and herb-derived compounds in experimental research models of allergic asthma. We screened published modern CM research results on the experimental effects of Chinese herbal formulae and herb-derived bioactive compounds for allergic asthma and their possible underlying mechanisms in English language articles from the Pub Med and the Google Scholar databases with the keywords allergic asthma, experimental model and Chinese herbal medicine. We found 22 Chinese herb species and 31 herb-derived anti-asthmatic compounds as well as 12 Chinese herbal formulae which showed a reduction of airway hyperresponsiveness, allergen-specific immunoglobulin E, inflammatory cell infiltration and a regulation of Th1 and Th2 cytokines in vivo, in vitro and ex vivo, respectively. Chinese herbal formulae and herbderived bioactive compounds exhibit immunomodulatory, anti-inflammatory and anti-asthma activities in different experimental models and their various mechanisms of action are being investigated in modern CM research with genomics, proteomics and metabolomics technologies, which will lead to a new era in the development of new drug discovery for allergic asthma in CM.     

Characteristics and Advantages of Traditional Chinese Medicine in the Treatment of Acute Myocardial Infarction

Objective: To obtain epidemiological data on Traditional Chinese Medicine (TCM) therapeutic status of acute myocardial infarction (AMI) and to determine TCM characteristics and advantages to improve the level of TCM prevention and treatment of AMI. Methods: Clinical epidemiology methods were used to register and survey the TCM therapeutic status of hospitalized AMI patients. In 2001, the Chinese Association of Integrative Medicine surveyed the therapeutic status of 3308 AMI patients hospitalized in 30 hospitals in Beijing and Shanghai from 2000-2001. The Beijing Collaborative Study Group on Therapeutic Status of Acute Myocardial Infarction (the Study Group) then conducted a 10-year-long register survey on hospitalized AMI patients in Third-grade A-Level TCM hospitals in Beijing. After 2002, the Study Group further surveyed the treatment conditions of AMI-hospitalized patients in 10 Second-grade A-Level TCM hospitals. The therapeutic status in 8 Third-grade A-Level Western medicine hospitals was surveyed in 2001 and 2005 as a control. In 2008, in cooperation with the China Association of Chinese Medicine, the Study Group further performed a survey at 26 Third-grade A-Level TCM hospitals nation-wide. Approximately 5000 cases were investigated to obtain authoritative data on the therapeutic status of AMI patients in TCM hospitals in China. Results: We found that Chinese herbal intravenous preparations may be beneficial in reducing the mortality of AMI. Major complications of AMI, such as heart failure and arrhythmia, were significantly less during the 10-year survey period. The mortality of hospitalized AMI patients showed a decline. TCM treatment was helpful for AMI patients in improving their quality of life. Ten-year dynamic monitoring showed that the ability to perform reperfusion and to use drugs appropriately, as well as an effort to carry out the Clinical Guidelines has made great progress in TCM hospitals. However, TCM hospitals still have some problems in treating AMI, including a lack of standardized TCM syndrome diagnosis, the need for syndrome differentiation and treatment standardization, and clinical skills in reperfusion and standardized drug treatment still need to be further improved. Compared with AMI patients in Western medicine hospitals during the same period, those in TCM hospitals had the following characteristics: they were admitted to hospital later; they were older when they had a heart attack; there were more females, they had more problems in their medical history, and they had more concomitant illnesses and complications. Therefore, the demographic baseline data were significantly different between AMI patients in TCM hospitals and those in Western medicine hospitals. This indicated that patients in TCM hospitals were more critical than those in Western medicine hospitals. Conclusions: TCM has special advantages in treating AMI. TCM hospitals are making continuous progress in standardized treatment of AMI, but further improvement is still required. AMI patients in TCM hospitals have some special characteristics, and their condition may be more critical. Further clinical research on TCM treatment of AMI is required.