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1.
Objective:To assess the efficacy of Chinese medicine(CM) on patients with pancreatic cancer(PC) in a retrospective population-based study.Methods:Between January 1,2013,and August 30,2016,according to whether received Western medicine treatment,the patients were included into either integrative medicine(IM) group or CM group.All enrolled patients were orally administrated with Gexia Zhuyu Decoction(膈下逐瘀汤) or Liujun Ermu Decoction(六君二母汤) by syndrome differentiation,twice a day,last for at least 2 months.The primary end point was overall survival(OS).Results:A total of 174 patients with PC were enrolled in this study.In stage Ⅰ/Ⅱ,the median OS was 20.5 months in the IM group [95% confidence interval(CI),12.499 to 28.501] and 11.17 months in the CM group(95% CI,5.160 to 17.180,P=0.015).The 1-and 2-year survival rates for the two groups were 47.0%,40.0% and 21.0%,21.0%,respectively.In stage Ⅲ/Ⅳ,median OS was 13.53 months(95% CI,8.665 to 18.395) in the IM group versus 6.4 months(95% CI,0.00 to 15.682) in the CM group,respectively(P=0.32).The 1-and 2-year survival rate for the IM and CM groups were 27.0%,7.0% and 20.0%,2.0%,respectively.Conclusions:Intervention of CM contributes to the different survival benefits for PC in different stages.Multimodality treatment might be a promising strategy for PC patients in early stage.While,in advanced stage,CM might be an alternative candidate for PC patients. 相似文献
2.
Objective: To evaluate the efficacy and safety of Chinese medicine(CM) plus Western medicine(WM) in the treatment of pediatric patients with severe hand, foot and mouth disease(HFMD) by conducting a prospective, controlled, and randomized trial. Methods: A total of 451 pediatric patients with severe HFMD were randomly assigned to receive WM therapy alone(224 cases, WM therapy group) or CM [Reduning Injection(热毒宁注射液) or Xiyanping Injection(喜炎平注射液)] plus WM therapy(227 cases, CM plus WM therapy group) for 7–10 days, according to a web-based randomization system. The primary outcome was fever clearance time, which was presented as temperature decreased half-life time. The secondary outcomes included the rate of rash/herpes disappearance within 120 h, as well as the rate for cough, runny nose, lethargy and weakness, agitation or irritability, and vomiting clearance within 120 h. The drug-related adverse events were also recorded. Results: The temperature decreased half-life time was 40.4 h in the WM therapy group, significantly longer than 27.2 h in the CM plus WM therapy group(P0.01). Moreover, the rate for rash/herpes disappearance within 120 h was 43.6%(99/227) in the CM plus WM therapy group, significantly higher than 29.5%(66/224) in the WM therapy group(P0.01). In addition, the rate for cough, lethargy and weakness, agitation or irritability disappearance within 120 h was 32.6%(74/227) in the CM plus WM therapy group, significantly higher than 19.2%(43/224) in the WM therapy group(P0.01). No drug-related adverse events were observed during the course of the study. Conclusions: The combined CM and WM therapy achieved a better therapeutic efficacy in treating severe HFMD than the WM therapy alone. Reduning or Xiyanping Injections may become an important complementary therapy to WM for relieving the symptoms of severe HFMD. 相似文献
3.
Objective
To analyze the effect of Chinese medicine (CM) on mortality and quality of life (QOL) of acquired immunodefificiency syndrome (AIDS) patients treated with combined antiretroviral therapy (cART).Methods
A random sample of AIDS patients enrolled in the National Chinese Medicine Treatment Trial Program (NCMTP) that met the inclusion criteria was included in this study. NCMTP patients were included as the CM+cART group, and those not in the NCMTP were included as the cART group. Survival from September 2004 to September 2012 was analyzed by retrospective cohort study. QOL was analyzed by cross-sectional study.Results
The retrospective cohort study included 528 AIDS patients, 322 in the CM+cART group and 206 in the cART group. After 8 years, the mortality in the CM+cART group was 3.3/100 person-years, which was lower than the cART group of 5.3/100 person-years (P<0.05). The hazard ratio (HR) for mortality in the cART group was 1.6 times that of the CM+cART group by Cox proportional hazard model analysis. After controlling for gender, age, marital status, education, and CD4+ T-cell count, the HR was 1.9 times higher in the cART group compared with the CM+cART group (P<0.05). The cross-sectional study investigated 275 AIDS patients. The mean scores of all QOL domains except spirituality/personal beliefs were higher in the CM+cART group than in the cART group (P<0.05).Conclusions
For AIDS patients, CM could help to prolong life, decrease mortality, and improve QOL. However, there were limitations in the study, so prospective studies should be carried out to confifirm our primary results.4.
Objective
To investigate the adjuvant therapeutic effects of fermented red ginseng (FRG) extract on non-small cell lung cancer (NSCLC) patients treated with chemotherapy.Methods
A total of 60 patients with advanced NSCLC were divided into two groups using a random number table, i.e., the gemcitabine plus cisplatin (GP) chemotherapy alone group (26 patients) and the FRG + GP chemotherapy group (34 patients), for 60-day treatment. Patients were then assessed according to the Fatigue Symptom Inventory, Chinese medicine symptoms score, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Karnofsky Performance Status Scale, and Functional Assessment of Cancer Therapy-Lung. In addition, chemotherapy toxicity and tumor biomarkers were measured.Results
For NSCLC patients after chemotherapy, FRG extract significantly improved the FSI score, CM symptoms score, psychological status, physical conditions, and quality of life and reduced chemotherapy toxicity, but the expression levels of carcinoembryonic antigen, cytokeratin-19 fragments, and neuron-specific enolase were not significantly different between the chemotherapy alone and the FRG + chemotherapy groups or between pre- and post-treatments.Conclusions
This study demonstrated that FRG extract had an adjuvant effect on advanced NSCLC patients treated with chemotherapy. Further studies with a larger sample size will verify the current findings.5.
Objective: To investigate the effect of Chinese medicine(CM) on survival of patients with stage Ⅱ and Ⅲ colorectal cancer(CRC). Methods: A total of 295 patients who received chemotherapy were assigned to Group 1. The other 171 patients received the same chemotherapy treatment combined with the usage of CM Jianpi Jiedu Formula(健脾解毒方, JPJD) for more than 3 months(Group 2). Patients' survival time, relapse and metastasis, and cause of death were observed. Cox proportional hazard regression models were established for the analysis of the effect of independent factors on the survival prognosis of patients with CRC. Results: The survival rate of patients in Group 2 was higher than that of Group 1(P0.05). Compared with Group 1, the mean survival time was prolonged by 5.594 months and the median survival time was prolonged by 6 months in Group 2(P=0.004). Cox regression analysis indicated that CM combined with chemotherapy provided significant protective effect, as observed with the improvements in the survival rates of CRC patients(P0.01). Conclusion: CM can improve the survival rate in patients with stage Ⅱ and Ⅲ CRC. 相似文献
6.
Objective: To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction(茵陈术附汤, YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus(HBV-ACLF) with cold pattern in Chinese medicine(CM). Methods: This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine(WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM(integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease(MELD) score, liver biochemical function, coagulation function and complications. Adverse events during treatment were reported. Results: The mortality was decreased 14.28% in the integrative treatment group compared with WM group(χ2=6.156, P=0.013). The integrative treatment was found to significantly improve the MELD score(t=2.353, P=0.020). There were statistically significant differences in aspartate transaminase, total bilirubin, indirect bilirubin, direct bilirubin and prothrombin time between the two groups(P0.05 or P0.01). The complications of ascites(χ2=9.033, P=0.003) and spontaneous bacteria peritonitis(χ2=4.194, P=0.041) were improved significantly in the integrative treatment group. No serious adverse event was reported. Conclusions: The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle "treating cold pattern with hot herbs" remains valuable to the clinical therapy.(Trial registration No. Chi CTR-TRC-10000766) 相似文献
7.
Objective
To develop an effective Chinese Medicine (CM) diagnostic model of coronary heart disease (CHD) and to confifirm the scientifific validity of CM theoretical basis from an algorithmic viewpoint.Methods
Four types of objective diagnostic data were collected from 835 CHD patients by using a self-developed CM inquiry scale for the diagnosis of heart problems, a tongue diagnosis instrument, a ZBOX-I pulse digital collection instrument, and the sound of an attending acquisition system. These diagnostic data was analyzed and a CM diagnostic model was established using a multi-label learning algorithm (REAL).Results
REAL was employed to establish a Xin (Heart) qi defificiency, Xin yang defificiency, Xin yin defificiency, blood stasis, and phlegm fifive-card CM diagnostic model, which had recognition rates of 80.32%, 89.77%, 84.93%, 85.37%, and 69.90%, respectively.Conclusions
The multi-label learning method established using four diagnostic models based on mutual information feature selection yielded good recognition results. The characteristic model parameters were selected by maximizing the mutual information for each card type. The four diagnostic methods used to obtain information in CM, i.e., observation, auscultation and olfaction, inquiry, and pulse diagnosis, can be characterized by these parameters, which is consistent with CM theory.8.
Objective: To develop a health-evaluating scale from a Chinese medicine(CM) perspective and reflecting CM conception of health. Methods: The Traditional Chinese Medicine Health Self-Evaluation Scale(TCM-50) was developed by verification of dimensions, formation of item pool, verification of scoring methodology, and pilot test of scale and item analysis. Results: TCM-50 composed of 50 items that could be classified into 4 dimensions including physiology and health, psychology and health, nature and health, and society and health. An examination of reliability and validity of TCM-50 yielded Cronbach's α coefficient of 0.927, and half coefficient of r was 0.876. The intraclass correlation coefficient of total score was 0.912. After using SF-36 questionnaire to evaluate the criterion validity, the Pearson r of the score of the two scales from the same participant was 0.740. Conclusions: TCM-50 has good reliability and validity, and can yield similar levels of efficacy as SF-36 in terms of evaluating people's overall health level. As a scale based on CM theory, TCM-50 is suitable for self-measuring the general health of Chinese patients. 相似文献
9.
Objective: To investigate the efficacy of integrated Chinese and Western medicine(IM) in the treatment of metastatic colorectal cancer(m CRC) in a cohort study.Methods: The survival outcome of patients receiving IM was compared with that of patients receiving Western medicine alone.The study design was adopted with "continuous administration of Chinese medicine for 3 months" as the exposure factor.Patients who met this exposure factor were assigned to the IM cohort(Group A,110 patients).Patients who did not meet this exposure factor were assigned to the Western medicine cohort(Group B,225 patients).The overall survival(OS),progression-free survival(PFS),and 1 st year,2 nd year,and 3 rd year survival in the two cohorts were compared.Results: The median OS in Group A and B were 18 months [95% confidence interval(CI) 15–21] and 16 months(95% CI 14–18),respectively,and the median PFS in Group A and B were 6 months(95% CI 4–7) and 5 months(95% CI 4–6),respectively.No statistically significant differences were observed between the groups(P=0.186,P=0.223).Group A demonstrated significantly longer OS and PFS than Group B in the following subgroups: female patients,patients with lesions in the right half of the colon,and those who received first-line treatment(P0.05).In the subgroup of elderly patients(age65 years),the OS in Group A was longer than that in Group B(P0.05).Conclusion: IM could prolong the survival of patients with m CRC.(Registry No.Chi CTR-IOR-17010497) 相似文献
10.
Objective
To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS).Methods
Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2).Results
Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (P<0.05).Conclusions
Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.11.
Background
Microvascular complications in type 2 diabetes (T2DM), including diabatic retinopathy (DR), diabetic kidney disease (DKD), diabetic peripheral neuropathy (DPN) are the leading causes of visual loss, end-stage renal disease or amputation, while the current therapies are still unsatisfactory. Chinese medicine (CM) has been widely used for treating diabetic mellitus. However, most of the previous studies focused on the single complication. The role of CM treatment in T2DM patients with 2 or multiple microvascular complications is not clear.Objective
To appraise the curative effect of CM in T2DM patients with 2 or multiple microvascular complications, and to compare the effects of stationary treatment and individualized treatment in T2DM patients with microvascular complications.Methods
This trial will be an 8-center, randomized, controlled study with 8 parallel groups. A total of 432 patients will be randomized to 8 groups: DR study group (32 cases) and a corresponding control group (32 cases), DR+DKD study group (64 cases) and a corresponding control group (64 cases), DR+DPN study group (64 cases) and a corresponding control group (64 cases), DR+DKD+DPN study group (56 cases) and a corresponding control group (56 cases). The control group will receive stationary treatment, and the study group will receive individualized treatment based on CM syndrome differentiation in addition to stationary treatment. The study duration will be 50 weeks, comprising a 2-week run-in period, 24 weeks of intervention, and 24 weeks of follow-up. The outcomes will assess efficacy of treatment, improvement in CM symptoms, safety assessments, adherence to the treatment, and adverse events.Conclusion
This study will provide evidence of evidence-based medicine for CM treatment in two or multiple microvascular complications caused by T2DM. (Registration No. ChiCTR-IPR-15007072)12.
Objective
To identify the commonalities between rheumatoid arthritis (RA) and diabetes mellitus (DM) to understand the mechanisms of Chinese medicine (CM) in different diseases with the same treatment.Methods
A text mining approach was adopted to analyze the commonalities between RA and DM according to CM and biological elements. The major commonalities were subsequently verified in RA and DM rat models, in which herbal formula for the treatment of both RA and DM identified via text mining was used as the intervention.Results
Similarities were identified between RA and DM regarding the CM approach used for diagnosis and treatment, as well as the networks of biological activities affected by each disease, including the involvement of adhesion molecules, oxidative stress, cytokines, T-lymphocytes, apoptosis, and inflammation. The Ramulus Cinnamomi-Radix Paeoniae Alba-Rhizoma Anemarrhenae is an herbal combination used to treat RA and DM. This formula demonstrated similar effects on oxidative stress and inflammation in rats with collagen-induced arthritis, which supports the text mining results regarding the commonalities between RA and DM.Conclusion
Commonalities between the biological activities involved in RA and DM were identified through text mining, and both RA and DM might be responsive to the same intervention at a specific stage.13.
Objective
To provide an objective reference for the syndrome types of Chinese medicine (CM) associated with pediatric primary nephrotic syndrome (PNS).Methods
A cross-sectional study was performed. Data on clinical symptoms, CM syndrome types, biochemical indices, and medications used were collected from 98 children with PNS. Then, the correlation between CM syndromes and biochemical indices, as well as medications used, was analyzed.Results
The four most common symptoms in children with PNS were brown urine, red tongue, excessive sweating, and swelling of the face and limbs. The syndromes of qi deficiency of Fei (Lung) and Shen (Kidney) (FSQD) and yin deficiency of Gan (Liver) and Shen (GSYD) were the most common main CM syndrome types. FSQD syndrome score correlated significantly with the total cholesterol level, urine protein/creatinine ratio, and urine IgG and albumin levels (P<0.01 or P<0.05). The use of maintenance glucocorticoids combined with immunosuppressive agents correlated with FSQD syndrome, and the use of maintenance glucocorticoids alone correlated with GSYD syndrome (P<0.05).Conclusion
Two of the most common CM syndrome types were FSQD and GSYD syndromes. FSQD syndrome may be caused by some factors related to lipid levels, protein loss, and the use of immunosuppressive agents. The use of maintenance glucocorticoids may cause GSYD syndrome14.
Objective: To study the efficacy of Chinese medicine (CM) on isolated systolic hypertension. Methods: Seven electronic databases were searched for randomized controlled trials (RCTs) published until August 2015. Subgroup analyses and meta-analysis were performed to assess the efficacy and safety of the included studies. Results: A total of 24 studies, including 2,096 patients (1,058 patients in the intervention group and 1,038 in the control group), were evaluated in the final analysis. Compared with a conventional therapy used alone, CM as additional intervention was more effective on systolic blood pressure [mean difference (MD)=–0.66, 95% confidence interval (CI)=(–0.97, –0.36), P<0.00001] and significantly diminished the pulse pressure [MD=–7.49, CI=(–12.69, –2.29), P<0.00001]. However it showed no additional benefit on diastolic blood pressure [MD=1.16, CI=(0.02, 2.29), P=0.87]. Adverse events were not explicitly reported in most RCTs. Conclusions: CM might be a promising approach for the elderly with isolated systolic hypertension, while the evidence for CM employed alone was insufficient. Considering the inherent limitations of the included studies, larger high-quality RCTs with extensive follow-up should be performed to validate our findings in the future. 相似文献
15.
Objective
To identify key symptoms of two major syndromes in chronic hepatitis B (CHB), which can be the clinical evidence for Chinese medicine (CM) doctors to make decisions.Methods
Standardization scales on diagnosis for CHB in CM were designed including physical symptoms, tongue and pulse appearance. The total of 695 CHB cases with dampness-heat (DH) syndrome or Pi (Spleen) deficiency (SD) syndrome were collected for feature selection and modeling, another 275 CHB patients were collected in different locations for validation. Key symptoms were selected based on modified information gain (IG), and 5 classifiers were applied to assist with models training and validation. Classification accuracy and area under receiver operating characteristic curves (AUC) were evaluated.Results
(1) Thirteen DH syndrome key symptoms and 13 SD syndrome key symptoms were selected from original 125 symptoms; (2) The key symptoms could achieve similar or better diagnostic accuracy than the original total symptoms; (3) In the validation phase, the key symptoms could identify syndromes effectively, especially in DH syndrome, which average prediction accuracy on 5 classifiers could achieve 0.864 with the average AUC 0.772.Conclusion
The selected key symptoms could be simple DH and SD syndromes diagnostic elements applied in clinical directly. (Registration N0.: ChiCTR-DCC-10000759)16.
Objective: To evaluate the quality and consistency of recommendations in the clinical practice guidelines(CPGs) for hypertension in Chinese medicine(CM). Methods: CM CPGs were identified from 5 electronic databases and hand searches through related handbooks published from January 1990 to December 2013. Three reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation(AGREE Ⅱ) instrument, and compared the CPGs' recommendations on CM syndrome pattern classification and treatment. Results: Five CM CPGs for hypertension were included. The quality score of the evidence-based(EB) guideline was higher than those of the consensus-based with no explicit consideration of evidence-based(CB-EB) and the consensus-based(CB) guidelines. Three out of five patterns in the CPGs were recommended by the EB guideline. Tianma Gouteng Formula(天麻钩藤复方) in the EB guideline was recommended mostly for hypertension patients with pattern of ascendant hyperactivity of Gan(Liver)-yang and pattern of yin deficiency with yang hyperactivity in the CPGs. Acupuncture and massage were recommended for Grade Ⅰ and Grade Ⅱ hypertension with severe symptoms weakening the quality of life in the EB guideline. For Grade Ⅰ and Grade Ⅱ hypertension, CM could be used alone, while for Grade Ⅲ hypertension, they should be used in combination with Western medicines. Conclusion: The quality of EB guideline was higher than those of CB and CB-EB CPGs in CM for hypertension and CM should be prescribed alone or combined with Western medicines based on the grade of hypertension. 相似文献
17.
Objective: To observe the clinical effects of Babaodan Capsule(八宝丹, BBD) combined with Qingyi Huaji Formula(清胰化积方, QYHJ) in treating patients with advanced pancreatic cancer. Methods: Eighty-one patients with advanced pancreatic cancer(from January 1, 2013 to December 31, 2014) were enrolled. Patients were assigned to two groups: QYHJ plus BBD group(40 cases) and QYHJ only group(41 cases), and there were no significant differences for other treatment between two groups. The survival and cancer-related symptoms were compared between two groups over two cycles of treatment. Results: The cancer-related symptoms of patients such as ascites, jaundice, pain, abdominal distension, anorexia and Karnofsky performance status of QYHJ plus BBD group were significantly improved as compared with those of the QYHJ group(P0.01). In addition, the 1-year survival rate of patients in QYHJ plus BBD group was longer than that in the QYHJ group(65% vs. 33%, respectively, P=0.0023). Conclusions: BBD with QYHJ is feasible treatment to prolong the survival of patients with advanced pancreatic cancer. However, it deserves to be further investigated in randomized clinical trials. 相似文献
18.
Objective:To assist decision-makers interpret and choose among conflicting meta-analyses,as well as to offer treatment recommendations based on current best evidence by performing a systematic review of overlapping meta-analyses regarding Shenyi Capsule(参一胶囊,SC) plus chemotherapy versus chemotherapy of non-small cell lung cancer(NSCLC).Methods:A literature search was conducted to select systematic reviews comparing SC plus chemotherapy with chemotherapy for NSCLC.Meta-analyses only composed of randomized controlled trials(RCTs) met the inclusion criteria.Two authors individually estimated the quality of meta-analysis and extracted data.The Jadad decision algorithm was applied to guarantee which meta-analysis provided the best original evidence.Results:A total of 5 meta-analyses were included.All the studies composed of RCTs or quasi-RCTs and were regarded as level-Ⅱ evidence.The scores of the Assessment of Multiple Systematic Reviews ranged from 3 to 6(median 4).A high-quality meta-analysis with more RCTs was chosen,which suggested that SC plus chemotherapy could increase incidence of short-term efficacy,improve the quality of life and survival rate in comparison to chemotherapy.However,there was no statistically significant difference between SC plus chemotherapy and chemotherapy regarding chemotherapy-induced side effect,such as liver and kidney function obstacle,leukopenia,hemoglobin decrement and gastrointestinal adverse reaction.Conclusions:Based on the best available evidence,treatment effect of SC plus chemotherapy was better than chemotherapy and did not increase side effects.Therefore,SC plus chemotherapy may be superior to chemotherapy for treating NSCLC.However,due to some limitations,SC plus chemotherapy should be cautiously considered,and further high-quality meta-analyses are needed. 相似文献
19.