Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in PubMed and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn’s disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmatic modern medicine by bridging the gap between the two medicinal cultures.     

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of angina pectoris of coronary heart disease (CHD): A protocol for systematic review and meta analysis

Background:Coronary heart disease (CHD) angina pectoris is a clinical syndrome in which episodic chest pain or chest discomfort is the main manifestation of temporary ischemia and hypoxia of the myocardium due to coronary atherosclerosis and coronary artery functional changes (spasm). A large amount of clinical evidence confirms that acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris can relieve the symptoms of angina pectoris and improve the performance of electrocardiograph ischemia; It still has obvious therapeutic effects in regulating the levels of cardiovascular regulatory peptides ET and cGRP. To better evaluate the effectiveness and safety of acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris, we designed a systematic evaluation program to provide a reliable scientific basis for the future use of this method.Methods:Search Pubmed database, Embase, Cochrane library, Chinese Biomedical Literature CD-ROM Database (CBMdisk), China Journal Network Full-text Database (CNKI), Wanfang Database, Web of Science (SCI-E), the retrieval time is established from each database Until October 2021, search for relevant eligible randomized controlled trials with keywords or subject terms “acupuncture”, “Chinese herbal medicine”, and “CHD angina”. Outcome indicators were clinical symptoms of CHD and angina pectoris, changes in electrocardiogram, changes in blood lipids, and significant improvement in traditional Chinese medicine syndromes before and after treatment. Two researchers independently carried out data extraction and quality assessment, and use RevMan5.3 software to carry out final data analysis and assessment.Results:This study provides a reliable clinical scientific basis for acupuncture combined with Chinese herbal medicine for the treatment of CHD and angina pectoris.Conclusion:Acupuncture combined with Chinese herbal medicine can effectively relieve the clinical symptoms of CHD and angina pectoris and improve the performance of electrocardiograph. At the same time, it can reduce the cardiovascular regulatory peptide ET and increase the level of cGRP in the patient''s plasma, thus confirming its effectiveness and safety.     

Cardiovascular effects of Danshen

Danshen is one of the most versatile Chinese herbal drugs that have been used for hundred of years in the treatment of numerous ailments. Because of its properties of improving microcirculation, causing coronary vasodilatation, suppressing the formation of thromboxane, inhibiting platelet adhesion and aggregation, and protecting against myocardial ischemia, it is widely used either alone or in combination with other herbal ingredients for patients with coronary artery disease and other cardiovascular diseases, in both China and other countries including the United States. This article provides an overview of its history, pharmacology, pharmacokinetics, clinical applications, side effects, interactions with Western drugs, and future prospects in the management of cardiovascular diseases.     

Chinese Herbal Therapy for the Treatment of Food Allergy

Traditional Chinese medicine (TCM) has been widely used in China to treat various diseases for thousands of years. Given its reputed effectiveness, low cost, and favorable safety profile, TCM is attracting great interest in Western societies as a source of therapy for an array of illnesses, including allergies and asthma. Although food allergy has not been described in the TCM literature, a novel treatment for food allergy, named the food allergy herbal formula-2 (FAHF-2), was developed using TCM principles. Using a well-characterized murine model of peanut allergy, FAHF-2 has been shown to be highly effective in providing long-term protection against peanut-induced anaphylaxis, with a high safety margin. Phase 1 human trials have demonstrated the safety of FAHF-2 in food allergic individuals. Currently, a phase 2 trial examining efficacy of FAHF-2 is on-going. Other TCMs also show a potential for treating food allergies in preclinical studies.     

Effectiveness and safety of Chinese herbal formula combined with western medicine for ankylosing spondylitis: A protocol for systematic review and meta-analysis

Background:Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease of the spine, which mainly invades the sacroiliac joint, spine, and large joints near the trunk, leading to fibrous and skeletal ankylosis and deformity, and can cause damage to the eyes, lung, cardiovascular, kidney and other organs. Chinese herbal formulas (CHF) is an important interventions of Traditional Chinese Medicine (TCM), and CHFs combined with western medicine are widely used in clinical practice to treat AS.Methods:Eight databases will be systematically retrieved from their inceptions to March 2021. Only randomized controlled trials (RCTs) of CHFs combined with western medicine for AS treatment will meet the inclusion criteria. The primary outcomes we focus on include clinical effectiveness rate, TCM syndrome score, TCM symptom score, Bath ankylosing spondylitis disease activity index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), chest expansion, nocturnal spinal pain, adverse reactions, erythrocyte sedimentation rate (ESR), and C protein response (CRP). The research screening, data extraction, and risk of bias assessment will be performed independently by 2 researchers, and divergence will be solved by a third researcher. Revman 5.3 software will be used for meta-analysis. The confidence of evidence will be graded using grading of recommendations assessment, development, and evaluation (GRADE) algorithm and methodological quality will be assessed adopting risk of bias in systematic reviews (ROBIS).Results:This systematic review (SR) will provide evidence-based medical evidence for AS therapy by CHF combined with western medicine and we will submit the findings of this SR for peer-review publication.Conclusions:This SR will provide latest and updated summary proof for assessing the effectiveness and safety of CHF combined with western medicine for AS.Registration number:INPLASY 202150089.     

Traditional Chinese medicine for irritable bowel syndrome: A protocol for meta-analysis

Background:Irritable bowel syndrom (IBS) is a common functional gastrointestinal disorder which is characterized as recurrent abdominal pain, abdominal discomfort, and abnormal bowel habits such as diarrhea, constipation, both or alternate appear. Although IBS is not fatal, it seriously affects the patients’ daily life and work. Western drug, such as antidiarrheals, gastrointestinal antispasmodic, often cannot get satisfying curative effects. However, the therapeutic effect of Traditional Chinese medicine (TCM) on IBS is very satisfactory which was shown in a large number of randomized controlled trials. Although TCM has been widely used in clinical practice, its relative effectiveness and safety have not been confirmed. Therefore, this study will use meta-analysis to verify the efficacy and safety of different types of TCM in the treatment of IBS.Methods:We search the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, Chinese Biomedical Literature Database, Pubmed, Embase, Web of Science, and the Cochrane library for all randomized controlled trial of TCM for the treatment of IBS from their inception to Oct 15, 2020. Two authors will independently select studies, extract data based on predesigned inclusion and exclusion criteria. Methodological quality assessment and risk of bias will be assessed using Cochrane bias risk tool. All data analysis will be conducted using Revman5.3, WinBUGS 1.4.3, and Stata14.2 software.Results:This study will compare the different outcome indicators of various studies directly and indirectly, and provide a high-quality synthesis of effectiveness and safety of different TCM methods for patients with IBS. The main outcome indicators include effectiveness, remission rate (no drug symptoms), relapse rate, clinical absolute score, and relative score. Secondary outcome indicators included related adverse reactions and serum serotonin concentration.Conclusion:The conclusion of this systematic review will provide a high-quality evidence based on the efficacy and safety of different TCM treatment methods for IBS.Registration number:This study protocol has been funded through a protocol registry. The registry number is INPLASY2020100052     

Regulatory effect of traditional Chinese medicine on gut microbiota in patients with atherosclerosis: A protocol for systematic review and meta-analysis

Background:Atherosclerosis is the pathological basis of many cardiovascular and cerebrovascular diseases, and its pathogenesis is complex. Recent studies revealed a significant role of gut microbiota in the onset and development of atherosclerosis. Traditional Chinese medicine has rich clinical experience and unique advantages in the treatment of atherosclerosis. A large number of studies have proved that traditional Chinese medicine has the functions of reducing blood lipid, regulating gut microbiota, and resisting inflammation. The aim of this systematic review is to observe the randomized controlled trial of traditional Chinese medicine in treating gut microbiota, so as to evaluate the effectiveness and safety of traditional Chinese medicine in treating atherosclerosis patients.Methods:The English database (PubMed, Web of Science, Embase, the Cochrane Library) and Chinese database (China National Knowledge Infrastructure, the Chongqing VIP Chinese Science, and Technology Periodic Database, Wanfang Database, and China Biomedical Literature Database) will be searched up to October 2020. We will also manually search the Chinese clinical trial register, conference papers, and unpublished studies or references. Randomized control trials of traditional Chinese medicine treatment of atherosclerosis were collected comprehensively, and 2 researchers will independently screen literature, data extraction, and evaluation the quality of literature methodology. The primary outcomes are lipid metabolism and gut microbiota and their metabolites. The secondary outcomes are the change of inflammatory markers. Meta-analysis was performed by RevMan 5.3.5 software. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to evaluate the outcome quality of evidence.Results:This study will comprehensively review the existing evidence of traditional Chinese medicine in treating atherosclerosis from the perspective of gut microbiota.Conclusion:This study will provide information on the effectiveness and safety of traditional Chinese medicine in treating atherosclerosis from the perspective of gut microbiota.Unique INPLASY number:INPLASY2020110056.     

Different Chinese herbal medicine therapy for idiopathic thrombocytopenic purpura: A protocol for systematic review and Bayesian network meta-analysis

Background:Idiopathic thrombocytopenic purpura (ITP) is a common immune system and blood system disease in clinical practice, and it is a hemorrhagic disease caused by immune factors causing platelet destruction and decreasing number of platelets. There is currently no effective treatment plan for ITP. At this stage, glucocorticoid and gamma globulin are mostly used in the treatment of ITP, and some patients use splenectomy to achieve therapeutic purposes, but the various treatment methods are inadequate. At this stage, a large number of randomized controlled studies have reported that Chinese herbal medicine has achieved good curative effect in the treatment of ITP. However, due to the variety of Chinese herbal medicine, there has been no evidence of the effectiveness and safety of Chinese herbal medicine in the treatment of ITP. Because of the above reasons, this study uses the network meta-analysis method based on Bayesian method to compare the clinical efficacy and safety of different kinds of Chinese herbal medicine in the treatment of ITP through direct and indirect comparison, in order to provide evidence-based medical support for the treatment of ITP with Chinese herbal medicine.Methods:This study uses the method of combining free words with theme words, and using computer to retrieve PubMed, EMbase, The Cochrane Library, WANFANG Database, CNKI, and VIP Database, etc, to collect the randomized control studies on Chinese herbal medicine in the treatment of ITP. The retrieval time is from the establishment of each database to January 2021, and the retrieval languages are Chinese and English. Two researchers independently read the title, abstract and full text of the article to determine whether it is included in the literature; In the event of a disagreement, a third researcher will join the discussion to resolve the disagreement; For the literature that lacks information, trying to contact the original author of the document to supplement it. The literature quality evaluation carried out by using the Stata 14.0 software to draw network and funnel plots, in accordance with the quality evaluation criteria of version 5.1.0 of the Cochrane System Evaluation Manual. Statistical analysis is performed by using ADDIS 1.16.8 software based on the Bayesian model.Results:This study will compare the clinical efficacy and safety of different types of Chinese herbal medicine in the treatment of idiopathic thrombocytopenic purpura through the method of network meta-analysis, and rank the different types of Chinese herbal medicine according to their effectiveness, and the results will be published in a peer-reviewed, high-quality academic journal.Conclusion:This study will find effective and safe Chinese herbal medicine for clinical treatment of ITP from the perspective of evidence-based medicine, and benefit more ITP patients.     

Efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS: A protocol for systematic review and meta-analysis

Background:Acquired immunodeficiency syndrome (AIDS) is one of the infectious diseases pandemic in the word. Traditional Chinese herbal medicine, as an alternative and complementary therapy of highly active antiretroviral therapy (HAART), has been put into the treatment of human immunodeficiency virus (HIV)/AIDS over 30 years due to its good therapeutic effects and high safety, while there is a lack of evidence-based medicine support. The purpose of this study is to explore the efficacy and safety of traditional Chinese herbal medicine combined with HAART for HIV/AIDS patients.Methods:We will search all randomized controlled trials of Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS from electronic databases including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang, China Science and Technology Journal Database and Chinese Biomedical Literature Database from inception to December 31, 2021. Literature screening will be conducted through EndNote software, and data extraction will be processed according to inclusion and exclusion criteria by two independent researchers. We will use Review Manager 5.4 and Stata 16 software for data analysis and publication bias test.Results:This systematic review and meta-analysis will provide a high-quality evidence for the efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS.Conclusion:The conclusion of this review will provide an objective assessment to evaluate whether Chinese herbal medicine integrated with HAART has the effect of improving the efficiency and depressing the toxicity.Registration number:INPLASY2021110082.     

Effectiveness and safety of combined antiplatelet and anticoagulant therapy: a critical review of the evidence from randomized controlled trials

Antiplatelet and anticoagulant drugs are effective for the prevention of arterial and venous thrombosis but patients continue to experience major cardiovascular events despite their use. Strategies to improve the effectiveness of antithrombotic therapies include selecting the optimal drug and dosing regimen, the use of combinations of antiplatelet and anticoagulant drugs and the development of new more effective drugs to replace existing therapies. Evidence from randomized controlled trials indicates that the combination of aspirin and an anticoagulant is more effective than aspirin alone for the prevention of recurrent cardiovascular events in patients with acute coronary syndrome and is more effective than anticoagulation alone for the prevention of thromboembolic events in patients with mechanical heart valves, but at a cost of increased bleeding. Randomized controlled trials provide no evidence for improved effectiveness of combination therapy compared with antiplatelet therapy alone for the prevention of recurrent cardiovascular events in patients with non-cardioembolic stroke or peripheral artery disease, or compared with anticoagulant therapy alone for the prevention of stroke in patients with atrial fibrillation. Despite lack of evaluation in randomized controlled trials, combination therapy is commonly used in patients with separate indications for antiplatelet therapy (e.g., acute coronary syndrome, recent coronary artery stent) and anticoagulant therapy (e.g., atrial fibrillation with at least one additional risk factor for stroke). Randomized trials are urgently required to evaluate the effectiveness and safety of combining antiplatelet and anticoagulant therapy in these settings.     

Preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced oral mucositis: A protocol for systematic review and meta analysis

Background:Oral mucositis (OM), one of the most common side effects for cancer patients who have undergone chemotherapy, can cause severe impairment to patients’ functional ability and impact their quality of life, resulting in delayed and/or incomplete treatment. Traditional Chinese medicine offers empirical herbal decoctions to gargle for the prevention of chemotherapy-induced OM; however, evidence for its clinical efficacy and safety is lacking. Therefore, we provide a protocol to evaluate the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Methods:We will comprehensively retrieve relevant articles published till August 15, 2020, in the following electronic databases: the Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, Chinese Science and Technique Journals Database, and the Wan-fang Database. Only randomized controlled trials will be included. We will use the criteria provided by the Cochrane Handbook for quality assessment and risk assessment of the included studies and use the RevMan 5.3 software for meta-analysis of the preventive effect and safety.Results:This study will assess the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM.Conclusion:This systematic review will provide evidence-based medical corroboration for the clinical application of the Chinese herbal medicine mouthwash in chemotherapy-induced OM.PROSPERO registration number:CRD42020206614.     

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of type 2 diabetes mellitus: A protocol for a systematic review and meta-analysis

Background:Diabetes has become a global public health problem and danger to human health. Diabetes is the main cause of blindness, kidney failure, heart attack, stroke, and lower limb amputation. According to the latest epidemiological survey and research, the overall prevalence of diabetes in mainland China is 11.2%, of which type 2 diabetes mellitus (T2DM) accounts for more than 90% acupuncture combined with Chinese herbal medicine have been widely used in the treatment of T2DM. However, we have not found a meta-analysis of their synergistic effects. Therefore, this systematic review and meta-analysis aims to evaluate the efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of T2DM.Method:From inception up to September 20, 2021, the PubMed, Web of Science, Embase, AMED, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases will be searched. The publication date or language will not be limited. We will apply a combination of medical keywords, including “acupuncture”, “Chinese herbal medicine”, and “type 2 diabetes mellitus”. We will also check other ongoing and unpublished studies in the clinical trial registry. At the same time, we will manually search all reference lists from relevant systematic reviews to find other eligible studies. We will use Review Manager software (REVMAN v5.3 Cochrane Collaboration) to meta-analyze the selected literature. The study for acupuncture combined with Chinese herbal medicine in the treatment of T2DM was a randomized controlled study. Two researchers will independently review the research selection, data extraction, and research quality assessments. Finally, we will observe the outcome measures.Results:This study will generate evidence-based data on the treatment of T2DM with acupuncture combined with Chinese herbal medicine and will provide new ideas and treatment modalities to investigate in future research.     

中药联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化疗效系统评价*

目的 系统评价中药联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化的有效性及安全性。方法 采用Cochrane 系统评价方法,计算机系统检索中国知识资源总库（CNKI）、万方学术期刊全文数据库、维普期刊全文（VIP）数据库、MEDLINE、PUBMED,检索2009年11月～2014年11月正式发表的文献。根据纳入和排除标准选择文献,按照相关质量评价标准进行评价,提取相关性研究指标,应用Revman5.3软件对数据进行Meta分析。结果 共纳入10项中西医结合治疗原发性胆汁性肝硬化的随机对照试验（RCT）,Jadad量表评分均为1～3分;纳入研究中提及治疗疗效的共有8个RCT文献,包括368例PBC患者,其中中药联合熊去氧胆酸（UDCA）治疗组187例,单用UDCA治疗的对照组181例。Meta分析显示中药联合UDCA治疗的有效率明显高于单用UDCA组,差异有统计学意义[OR=3.83,95%CI （2.09,7.02）,P<0.0001];联合组患者血清ALP、GGT、TBIL、ALT、AST、TBA水平下降较对照组更明显。结论 中药联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化的疗效显著优于单用熊去氧胆酸胶囊治疗,但该类研究的论文质量不高,可信度较低。     

Effects and safety of traditional Chinese medicine on the gut microbiota of an adult with chronic kidney disease: A protocol for systematic review and meta-analysis

Background:Studies have reported that changes in the abundance of gut microbiota may explain the medically helpful responses towards traditional Chinese medicine (TCM), an essential part of alternative and complementary medicine, in treating chronic kidney disease (CKD). This study aimed to illuminate the changes in the abundance of gut microbiota of TCM with CKD.Methods:The meta-analysis was performed in the PubMed, Web of Science, EMBASE CNKI, WanFang, VIP, and CBM databases, from its inception to October 2021 to discriminate randomized controlled trials and examine the effects of TCM on CKD. Two researchers independently performed literature selection, data extraction, and quality assessment. The risk of bias of the included studies was estimated by taking into consideration the characteristics including random sequence generation, allocation concealment, blinding of patients, blinding of outcome assessment, completeness of outcome data, selective reporting, and other bias using Cochrane Collaboration''s tool for assessing the risk of bias.Results and Conclusions:From the perspective of intestinal flora, this study will provide high-quality evidence for the effectiveness and safety of TCM for CKD. It provides a new therapeutic approach for treating CKD with Chinese herbal medicine combined with Western medicine.Inplasy registration number:INPLASY2021100118.     

Traditional Chinese medicine for acute coronary syndrome: A meta-analysis of clinical manifestations and objective indicators

Background:Modern clinical trials and experimental researches of traditional Chinese medicine (TCM) have been conducted for decades and provided support for the prevention and treatment of acute coronary syndrome (ACS). However the level of evidence and the proper application of TCM were still barely satisfactory.Methods:In this study, we divided ACS into 3 different stages, including unstable angina, acute myocardial infarction, and post myocardial infarction. Then we systematically reviewed and meta-analyzed the existing randomized controlled trials on both clinical manifestations and objective indicators, in these 3 aspects.Results:The results indicate that TCM can both improve the clinical manifestations and ameliorate the objective parameters in different courses of ACS, including C-reactive protein in unstable angina, left ventricular ejection fraction in acute myocardial infarction and post myocardial infarction. And the incidence of short-term cardiovascular events are lower in TCM intervention group. Some of the improvements lead to potential long-term benefits.Conclusion:TCM treatment is beneficial to different courses of ACS. To acquire more solid and comprehensive evidence of TCM in treating ACS, more rigorously designed randomized controlled trials with longer follow-up duration are warranted.     

Is there a role for herbal medicine in the treatment of pancreatic cancer?. Highlights from the "44th ASCO Annual Meeting". Chicago, IL, USA. May 30 - June 3, 2008

One of the greatest challenges in the treatment of pancreatic cancer remains its inherent lack of beneficial response to cytotoxic chemotherapy. According to the encyclopedic knowledge on herbal medicine regimen and clinical experience accumulated for centuries, traditional Chinese medicine can provide new avenues for alternative treatments of pancreatic diseases. Chinese herbal extracts have been widely used for the treatment of various cancers, but objective information on their efficacy in pancreatic cancer is lacking. This article provides a summary of herbal medicine, presented at the Annual Meeting of ASCO, 2008. The clinical applications of these active compounds warrant further investigation in randomized, controlled clinical trials.     

Effectiveness and safety of acupuncture for chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis

Background:Chronic Obstructive Pulmonary Disease (COPD) is the most common respiratory disease in clinic. Traditional Chinese medicine (TCM) lung rehabilitation has gradually been valued in the field of prevention and treatment of COPD. Acupuncture, as an important part of TCM lung rehabilitation, is carried out in clinical extensively and application. It has the advantage of improving the symptoms and quality of life of COPD cases, but the evidence-based proof is limited.Methods:Eight databases will be systematically retrieved from their inceptions to December 2021. This study will include randomized controlled trials of acupuncture in the treatment of COPD with stable stage. The main outcome will include clinical effective rate, TCM symptom score, quality of life, dyspnea, exercise capacity, lung function, frequency of acute exacerbation, adverse events. Literature screening, quality evaluation and information extraction will be completed by two independent researchers. Revman 5.3 software will be used to perform meta-analysis. Assessment of multiple systematic reviews-2 tool will be used for evaluating the methodological quality of systematic review (SR), grading of recommendations assessment will for rating the quality of evidence, and consolidated standards of reporting trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture tool will for assessing the reporting quality of randomized controlled trials.Results:The findings of this SR will be presented at relevant conferences and submitted for peer-review publication.Conclusions:The findings of this SR will provide up-to-date summary proof for evaluating the effectiveness and safety of acupuncture for COPD.     

Efficacy and safety of external therapy of TCM for primary dysmenorrhea: A protocol for systematic review and meta-analysis

Background:Primary dysmenorrhea (PD) is a painful disease that severely affects the daily lives of young women. External therapy using traditional Chinese medicine (TCM) is widely used in the clinical treatment of this disease and has achieved a good effect. There are many kinds of TCM external therapies, but the effectiveness, safety, and advantages of various methods have not been confirmed by high-quality meta-analyses. The purpose of this study was to evaluate the efficacy and safety of representative TCM external therapies in patients with PD.Methods:Published randomized controlled trials that assessed the efficacy of these interventions in patients with PD were included. We searched the following electronic databases: PubMed, Cochrane Library, Embase, Web of Science, China Science and Technology Journal, China National Knowledge Infrastructure, Wanfang, and Chinese Biomedical Literature Database and other sources. The main outcomes included menstrual pain intensity and the clinical effectiveness rate. The secondary outcomes were the quality of life and safety. The meta-analysis will be performed using the Review Manager version 5.3 software.Results:We will provide more practical results investigating the efficacy of external TCM therapy with high clinical frequency for PD patients in several respects, including the improvement of menstrual pain intensity, quality of life, and safety.Conclusion:This review systematically reviews the effectiveness and safety of common TCM external therapies for PD and provides clinicians with the best treatment options.Ethics and dissemination:This systematic review aimed to evaluate the efficacy and safety of external TCM therapy for PD. Since all data included were published, the systematic review did not require ethical approval.Registration number:CRD42021297078.     

肠道菌群失调与心血管疾病及其中医药调控研究进展

心血管疾病的发病率和死亡率正随着人口老龄化及城镇化的推进而呈持续升高之势,严重威胁人类的生命健康安全。心血管疾病的起病及病程进展受多种因素影响,肠道菌群失调作为其中之一吸引了众多目光。肠道菌群是存在于胃肠道内与人体互利共生的微生物群,越来越多的研究表明,肠道菌群与心血管疾病相互影响,二者互为因果,通过调节肠道菌群靶向干预心血管疾病可成为新的治疗思路。现代研究发现中药复方、中药单体及针灸可有效纠正肠道菌群紊乱,上调益生菌数量,恢复肠道屏障功能,减轻炎症反应。基于上述研究,该文总结了肠道菌群及其代谢产物与心血管疾病之间的相互作用,还对部分中医药调控肠道菌群,恢复肠道菌群动态平衡,从肠治心,干预心血管疾病的治疗作用进行了归纳,以期为心血管疾病的防治提供新的思路和可行性方案。     

Efficacy and safety of Maxing Shigan Decoction in the treatment of chronic obstructive pulmonary disease: A protocol for a systematic review and meta-analysis

Background:Chronic Obstructive Pulmonary Disease (COPD) is currently the fourth leading cause of death in the world but is projected to be the 3rd leading cause of death by 2030. Chronic obstructive pulmonary disease is an important public health challenge, which can be prevented and treated. COPD is an important public health challenge, both preventable and treatable. In China, Maxing Shigan Decoction (MSD) has been used as a traditional Chinese medicine compound for the treatment of respiratory diseases for thousands of years. In order to evaluate the efficacy and safety of MSD in the treatment of COPD, we need to conduct meta-analysis and systematic reviews.Methods:The data comes from 7 publicly published databases, including: PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), EMbase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database(CBM), VIP Database, and Wanfang database. We will include randomized controlled trials (RCTs) to evaluate the effectiveness and safety of MSD in the treatment of COPD. Result measurement indicators include: TCM syndrome scores, lung function indicators, serum inflammatory factors, blood gas indicators, adverse reactions. RevMan 5.0 will be used for meta-analysis.Results:This study will provide high-quality evidence for the effectiveness and safety of traditional Chinese medicine therapy for COPD.Conclusion:The results of this study will help us determine whether MSD can effectively treat COPD.Ethics and dissemination:All analyses in this study are based on previously published research, so this study does not require ethical approval or patient consent. We will disseminate our findings electronically or in print by publishing results in peer-reviewed journals.OSF registration number:DOI 10.17605/OSF.IO/H5UNB.