The traditional Chinese medicine prescription patterns of Sjögren׳s patients in Taiwan: A population-based study

Ethnopharmacological relevance

Traditional Chinese medicines (TCM), when given for symptom relief, have gained widespread popularity among Sjögren?s patients. The aim of this study was to analyze the utilization of TCM among Sjögren?s patients in Taiwan.

Materials and methods

The usage, frequency of service, and the Chinese herbal products prescribed among Sjögren?s patients were evaluated in a cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of a TCM.

Results

More than 90% of Sjögren?s patients received TCM out-patient services at least once during the study period. Patients with secondary Sjögren?s syndrome were more likely to seek TCM treatment than those with primary Sjögren?s syndrome. The aOR for those suffering from at least one rheumatologic disease was 1.56 (95% CI: 1.26–1.93), those with two rheumatologic diseases was 1.98 (95% CI: 1.29–3.04), while those with three or more rheumatologic diseases was 7.86 (95% CI: 1.09–56.58). Compared to Sjögren?s patients who used no medical treatment, the aOR for those who took one type of conventional medication was 1.55 (95% CI: 1.25–1.92), those who took two types was 1.98 (95% CI: 1.60–2.47) while those who took three or more types was 2.91 (95% CI: 2.20–3.84). Qi-Ju-Di-Huang-Wan (Lycium Berry, Chrysanthemum, and Rehmannia Pill) was the most frequently prescribed formula among Sjögren?s patients.

Conclusion

Qi-Ju-Di-Huang-Wan is the most commonly prescribed Chinese herbal formula for Sjögren?s syndrome and its effects should be taken into account by healthcare providers.     

Women’s preconception health patterns in traditional Chinese medicine as a predictor of fertility outcomes

ObjectiveTo examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes.MethodsA community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher’s exact tests, logistic regression models, general linear models and the Cox proportional hazard model.ResultsThe fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55–801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90–23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1–3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12–3.25) pattern had a higher risk of spontaneous miscarriage.ConclusionThree unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women’s fecundability and birth outcomes.     

Nepalese traditional medicine and symptoms related to Parkinson׳s disease and other disorders: Patterns of the usage of plant resources along the Himalayan altitudinal range

Ethnopharmacological relevance

Nepal is a hotspot for cultural and biological diversities. The tremendous diversity of ecosystems and climates and the blend of medicinal practices inherited from Ayurvedic and Traditional Tibetan Medicine are well suited to a study aimed at discovering information about medicinal plants to treat Parkinson’s disease (PD). In addition, this study across Nepal’s altitudinal range is relevant to understanding how cultural and ecological environments influence local traditional medicines. The aim of the study is to document the uses of medicinal plants in three different eco-geographical areas of Nepal (Chitwan–Panchase–Mustang) to treat symptoms related to PD. A second goal is to analyze the impact of culture and environment on the evolution of traditional medicine.

Materials and methods

The study was conducted in five communities located in three different eco-geographical environments and at altitudes ranging from 300 m to 3700 m. We interviewed a total of 56 participants (local people, folk, Ayurvedic and Amchi healers) across the three research areas. We conducted open-ended interviews to document the uses of medicinal plants to treat PD-related symptoms. Information provided by the interviewees suggested that the medicinal plants are also used to treat symptoms related to other disorders. We determined the informant consensus factor as well as the importance of specific plant species to (i) identify plants that are the best candidates to be analyzed experimentally for their potential to treat PD and (ii) perform a cross-cultural comparison of the three areas of study.

Results

This study reports the local uses of 35 different plant species along the Chitwan–Panchase–Mustang altitudinal range. We identify a total of eight plant species that were used in all three research areas, and more specifically one species used to treat PD-like symptoms. We identify a potential dual protective activity of medicinal plants used to treat PD-related symptoms as recent literature suggests that these plants also have anti-cancer properties. In addition, we document that the presence of Ayurvedic healers could influence local practices and that local practices could influence local Ayurvedic practices.

Conclusions

This study documents the uses of medicinal plants to treat symptoms related to PD and other disorders across the Chitwan–Panchase–Mustang altitudinal range. PD is a neurodegenerative disease affecting a growing number of people worldwide. No cures are available to slow the death of the neurons, and there is a critical need to work towards innovative therapeutic strategies. We identify medicinal plants based on traditional practices to help develop a cure for PD. The three areas of study were chosen for their ecological and cultural diversities, and two of these are included in conservation programs (Panchase Protected Forest and Annapurna Conservation Area). The documentation of community–natural resource relationships is another step in the preservation of traditional practices and local biodiversity and a reflection of communities’ rights in the design of conservation programs.     

Is the yin–yang nature of Chinese herbal medicine equivalent to antioxidation–oxidation?

It has been suggested that yin-yang theory described in traditional Chinese medicine is somewhat equivalent to the modern theory of antioxidant-oxidant balance. Some yin-tonic Chinese herbal medicines possess antioxidant properties. In this context, the DNA protective effect of 12 yin-tonic and 13 yang-tonic herbs were tested using the single cell gel electrophoresis (comet) assay. Lymphocytes from three healthy subjects were pre-incubated with aqueous herb extract, and the comet assay was performed on treated, untreated, challenged and unchallenged cells in parallel, oxidant challenge being induced by 5 min exposure to hydrogen peroxide. Results using this ex vivo cellular assay showed protection by some herbs. Seven out of 12 yin-tonic Chinese herbs demonstrated decreased DNA damage after treatment while 10 out of 13 yang-tonic herbs showed protection. Among 25 herbs tested, rhizome of Ligusticum sinensis Oliv. and aerial part of Artemisia annua L. demonstrated greatest DNA protective effect. Results indicated that the yin nature of herbs may not be necessarily associated with superior antioxidative effect to yang-tonic herbs, at least in terms of DNA protection against oxidant challenge.     

The WNT/β-catenin pathway mediates the anti-adipogenic mechanism of SH21B, a traditional herbal medicine for the treatment of obesity

Aim of the study

This study was conducted to elucidate the molecular mechanisms of SH21B, a traditional Korean herbal medicine commonly used for the treatment of obesity.

Materials and methods

3T3-L1 preadipocytes were differentiated into adipocytes in the presence or absence of SH21B. Changes in mRNA or protein levels were analyzed using microarray, real-time polymerase chain reaction and western blotting analyses. Small interference (si)RNA transfection experiments were conducted to elucidate the essential role of β-catenin.

Results

Microarray analyses showed that components of the WNT/β-catenin pathway including β-catenin, cyclin D1 and dishevelled 2 were up-regulated more than two-fold as a result of SH21B treatment during adipogenesis, which were confirmed by real-time PCR and western blotting. Modulation of the WNT/β-catenin pathway by SH21B resulted in the nuclear accumulation of β-catenin. Both intracellular lipid droplet formation and expressions of adipogenic genes including PPARγ, C/EBPα, FABP4 and LPL, which were inhibited by SH21B, were significantly recovered by β-catenin siRNA transfection.

Conclusions

SH21B modulates components of the WNT/β-catenin pathway during adipogenesis, and β-catenin plays a crucial role in the anti-adipogenic mechanism of SH21B.     

Network pharmacology unveils spleen-fortifying effect of Codonopsis Radix on different gastric diseases based on theory of ‘‘same treatment for different diseases” in traditional Chinese medicine

Objective: Same treatment for different diseases is a unique treatment strategy under the guidance of traditional Chinese medicine(TCM) theory.Codonopsis Radix(Codonopsis pilosula,Dangshen in Chinese)with spleen-fortifying effect was employed to understand the strategy of Same treatment for different diseases,based on its common mechanism in the treatment of gastric diseases including gastric ulcer,gastritis and gastric cancer via network pharmacology research.Methods:Network pharmacology research methods were used to analyze the interaction network and potential mechanisms of Dangshen in treating gastric ulcer,gastritis and gastric cancer.The active components and their target proteins of Dangshen were integrated from TCMSP,BATMAN-TCM databases.The targets of gastric ulcer,gastritis and gastric cancer were collected through GeneCards,PubMed,TDD and DisGeNET Database.Through screening,the key components and the key targets of Dangshen in treating gastric ulcer,gastritis and gastric cancer were obtained.After KEGG pathway analysis and GO analysis,the important pathways and biological processes were analyzed.Results:Through data and literature mining,the common and specific pharmaceutical effects and mechanism of Dangshen were summarized in these three gastric lesions.It was shown that Dangshen mainly acted on gastric ulcer,gastritis and gastric cancer through the overall regulation of the PI3K-AkT signaling pathway.With the development of the disease,it will gradually increase the control of inflammation through TNF,NF-κB and other inflammation-related signaling pathways to reduce inflammatory damage.For tumorigenesis,it pays more attention to inhibiting the ErbB signaling pathways to reduce the proliferation and migration of tumor cells.In addition,Dangshen's regulation of HIF-1 signaling pathway may also be beneficial for the treatment of gastric ulcer,gastritis and gastric cancer.Conclusion:Dangshen achieves spleen-fortifying effect on gastric diseases including gastric ulcer,gastritis and gastric cancer through multiple targets in multiple pathways,especially PI3K-AKT pathway and HIF-1 pathway.It could provide a scientific basis for understanding the strategy of Same treatment for different diseases in traditional Chinese medicine.     

Integrating traditional Chinese medicine into mainstream healthcare system in Hong Kong,China——A model of integrative medicine in the HKU-SZ Hospital

The European Congress for Integrative Medicine 2015 Global Summit on Integrative Medicine and Healthcare in Greater Copenhagen has successfully promoted integrative medicine to the public once again. Integrative medicine, which is called the art and science of healthcare by Nordic Integrative Medicine, has been widely used in the world. In Hong Kong, integrated traditional Chinese and Western medicine, which is also known as the Chinese version of integrative medicine, provides a valuable reference for the development of integrative medicine in the world. In this article, we introduce the development of traditional Chinese medicine in Hong Kong and an integrated traditional Chinese and Western medicine model in the University of Hong Kong-Shenzhen Hospital.     

Pharmacokinetics and tissue distribution of 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside from traditional Chinese medicine Polygonum multiflorum following oral administration to rats

Ethnopharmacological relevance

Polygonum multiflorum is an important traditional Chinese medicine used for health promotion and disease treatment. One major bioactive compound in P. multiflorum is a stilbene glycoside (2,3,5,4′-tetrahydroxystilbene-2-O-β-d-glucoside, PM-SG), which possesses antioxidative, anti-inflammatory and endothelial-protective activities.

Materials and methods

The purpose of the present study was to investigate in vivo pharmacokinetics and tissue distribution of PM-SG after oral administration of Polygonum multiflorum extract to rats by using a reversed-phase high-performance liquid chromatography coupled with liquid-liquid phase extraction. The pharmacokinetic parameters were determined using both compartmental and non-compartmental analyses.

Results

All calibration curves for PM-SG in rat plasma and tissues were linear (all r² > 0.99) over the range of 0.27-185.00 μg/ml. The intra- and inter-day variations were less than 3% at concentration range of 8.7-131.2 μg/ml and good overall recoveries (97.7-101.5%) were obtained at the same range. The maximum concentration (C_max) and the time to reach this concentration (T_max) of PM-SG were 31.9 μg/ml and 40.0 min, respectively. The pharmacokinetic profiles estimated by fitting two-compartment and non-compartment models revealed that PM-SG was rapidly absorbed into the body fluids and widely distributed throughout the body, with great efficiency of utility, followed by quick elimination. The highest PM-SG levels were detected in liver and lungs (90.3 ± 20.8 μg/g and 86.8 ± 9.0 μg/g, respectively) whereas little in brain and testes, indicating PM-SG can hardly penetrate the blood-brain and blood-testicle barriers.

Conclusions

This was the first report on the favorable pharmacokinetic profiles of PM-SG in rat plasma and tissues after oral administration. It may provide a meaningful basis for clinical application of such a bioactive compound of herbal medicines.     

Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence—taking stroke as an example

ObjectiveTo explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine (TCM) nursing taking stroke as an example.MethodsFirst, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search; conducted an evaluation of evidence quality and the grade of the evidence; and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.ResultsThrough the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence; these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64–9.99 points and a more scientific and standardized recommendation-formation process.ConclusionOwing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.     

An investigation of the influence of intestinal flora in external traditional Chinese medicine therapyOA

External therapy, which has been used for millennia to treat disease, has now become the newest member of complementary and alternative therapies. A growing number of clinical studies and animal experiments have shown that external therapy exerts a positive effect on the intestinal flora. In this paper, we review the research related to external therapy on various systemic diseases and focus on changes in the intestinal flora. We found that studies on external therapy are dominated by acupunctur...     

Inhibition of cytokine production by the traditional oriental medicine, 'Gamcho-Sasim-Tang' in mitogen-stimulated peripheral blood mononuclear cells from Adamantiades-Behçet's patients

Gamcho-Sasim-Tang (GS-Tang) is a traditional Chinese medication, which has been successfully used in Korea for the treatment of Adamantiades-Beh?et's disease (ABD). We investigated the modulation effects of GS-Tang on cytokine production from phytohaemagglutinin-stimulated peripheral blood mononuclear cells of Beh?et's patients. ABD is a systemic inflammatory disorder and might involve immune dysfunction. Cytokines involved in the regulation of inflammatory reactions and immune responses may play a role in the pathogenesis of ABD. GS-Tang (1 mg/ml) significantly inhibited the production of proinflammatory cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta), compared to absence of GS-Tang (by 42.0+/-6.6% inhibition for TNF-alpha and 95.9+/-5.7% for IL-1 beta, P<0.05). GS-Tang also inhibited the production of IFN-gamma, immunoregulatory T helper cell type 1 cytokine, by 80.2+/-5.3% (P=0.001). The inhibitory effects of GS-Tang on cytokine production showed dose-dependent manner. Our results suggest that GS-Tang might have anti-inflammatory and immuno-regulatory effects through the cytokine modulation.     

Efficacy of Chinese herbal compound GAPT for the treatment of Alzheimer’s disease during mouse/rat studies: A systematic review and meta-analysis

ObjectiveTo evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease (AD) and to provide current evidence for potential treatment mechanisms.MethodsA comprehensive search of PubMed, Embase, Web of Science, SinoMed, China Network Knowledge Infrastructure, Wanfang Data, and Chinese Scientific Journals Database was performed to identify GAPT mouse/rat studies published from inception to July 2019. The outcomes extracted were Morris water maze results and molecular biological quantifications.ResultsA total of 19 studies were included in this analysis. The analysis indicated that GAPT was able to significantly improve learning and memory abilities compared with model mice/rats, as assessed by Morris water maze, and showed similar efficacy as donepezil. Subgroup analyses showed that low, medium, and high doses resulted in no obvious dose-dependent effects. Additionally, the GAPT group had significantly reduced expression levels of amyloid-beta peptide, presenilin 1, phosphorylated tau, acetylcholinesterase, and glycogen synthase kinase-3β, but increased expression levels of Shank1, and protein phosphatase-2A, and improved synapses structures compared with the model group, and subgroup analyses showed the medium dose of GAPT was superior to the low and high doses.ConclusionsBased on the pooled analysis, GAPT improved the learning and memory abilities and regulated the expression levels of related proteins during the progression of AD in mouse/rat studies. Notably, the medium dose of GAPT exhibited better performance than the other two doses, providing experimental evidence for further applications of GAPT during clinical practice.     

Study on the mechanism of cholic acid derivatives in traditional Chinese medicine based on the regulation of gene expressionOA

Objective: To investigate the pharmacological action and mechanism of cholic acid derivatives in traditional Chinese medicine(TCM) based on the regulation of gene expression.Methods: Genome-wide gene expression profiles of Michigan Cancer Foundation-7(MCF-7) cells treated with or without 4 cholic acid derivatives were detected by gene chip technology. Similarities in upregulated and downregulated genes were analyzed using the Connectivity Map(CMap) database. The affinity between cholic acid deri...     

A modified formulation of Chinese traditional medicine improves memory impairment and reduces Aβ level in the Tg-APPswe/PS1dE9 mouse model of Alzheimer's disease

Ethnopharmacological relevance

SuHeXiang Wan (SHXW), a Chinese traditional medicine has been used orally for the treatment of seizures, infantile convulsion, stroke and so forth. Previously, we reported the effects of modified SHXW essential oil mixture of the fragrance containing herbs on the sedative effect, anticonvulsant property and antioxidative activity after fragrance inhalation.

Materials and Methods

This study was undertaken to evaluate beneficial effects of a modified recipe of SHXW (termed as KSOP1009) consisting of a ethanol extract of 8 herbs including resin of Liquidambar orientalis Miller, seed of Myristica fragrans Houtt., rhizome of Cnidium officinale Makino, lumber of Santalum album L., fructus of Piper longum L., flower buds of Eugenia caryophyllata Merrill et Perry, pollen of Typha orientalis Presl., and root of Salvia miltiorrhiza Bunge in the neurodegenerative diseases such as Alzheimer's disease (AD). The transgenic mice of AD, Tg-APPswe/PS1dE9, were fed KSOP1009 or as a positive control, donepezil for 3 months from 4.5 months of age. Behavioral, immunological and ELISA analyses were used to assess memory impairment, Aβ accumulation and plaque deposition in the brain. Other in vitro works were performed to examine whether KSOP1009 inhibits the Aβ_1-42-induced neurotoxicity in human neuroblastoma cell line, SH-SY5Y cells.

Results

Intake of KSOP1009 improved the Aβ-induced memory impairment and suppressed Aβ levels and plaque deposition in the brain of Tg-APPswe/PS1dE9 mice as much as that of donepezil treatment. KSOP1009 prevented the down-regulation of phospho-CREB and increased AKT phosphorylation in the AD-like brains. Moreover, KSOP1009 suppresses Aβ-induced apoptosis and ROS production in SH-SY5Y cells.

Conclusion

The present study suggests that KSOP1009 may develop as a therapeutic drug for treatment of AD patients.     

The West Learns from China,Creating Chinese New Medicine-Academician of Western Medicine TANG Zhao-you’s View on the Integration of Traditional Chinese and Western Medicine

TANG Zhao-you was born in Xinhui,Guangdong province on December 26^th,1930.He is an oncologist,founder of small liver cancer research,academician of Chinese Academy of Engineering,director of Liver Cancer Institute of Fudan University,professor,and doctoral supervisor.He has been working on liver cancer research for more than 40 years,pioneering the use of alpha-fetoprotein(AFP)in early detection of liver cancer and establishing the concept and method of early detection and diagnosis of liver cancer.He carried out surgery for small liver cancer and later pioneered the excision surgery after big liver cancer getting small which has saved many patients'lives.     

New insights for infection mechanism and potential targets of COVID-19: Three Chinese patent medicines and three Chinese medicine formulas as promising therapeutic approachesOA

The coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) with high pathogenicity and infectiousness has become a sudden and lethal pandemic worldwide. Currently, there is no accepted specific drug for COVID-19 treatment. Therefore, it is extremely urgent to clarify the pathogenic mechanism and develop effective therapies for patients with COVID-19. According to several reliable reports from China, traditional Chinese medicine(TCM), especially f...     

Optimization of evidence-based research in the prevention and treatment of coronary heart disease with traditional Chinese medicine: A comprehensive reviewOA

Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems remain that require solutions. In the prevention and treatment of CHD with traditional Chinese medicine(TCM), great therapeutic advantages have been demonstrated. However, the expression of its advantages relies on scientific evidence-based research and evaluation, which require fur...