Systematic Review and Meta‑analysis of Shenfu Injection on Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease

The objective of the study was to systematically evaluate the efficacy and safety of Shenfu injection in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 15 randomized controlled trials involving 1198 patients were included. The results of meta?analysis showed that compared with the control group, the experimental group can improve the total clinical effective rate in AECOPD patients (relative risk = 1.15, 95% confidence interval [CI] [1.09, 1.21], P < 0.000 01), improve the pulmonary function levels: forced expiratory volume in one second (FEV1) (standardized mean difference = 1.88, 95% CI [0.89, 2.88], P = 0.000 2) and the FEV1 /forced vital capacity (FVC) ratio (FEV1 /FVC) (mean difference [MD] = 3.96, 95% CI [2.74, 5.19], P < 0.000 01); improve the arterial blood oxygen partial pressure (MD = 6.03, 95% CI [4.58, 7.48], P < 0.000 01), and reduce the arterial blood partial pressure of carbon dioxide (MD = ?4.59, 95% CI [?6.91, ?2.26], P = 0.000 01), and the white blood cell count in pulmonary infection may be improved (MD = ?1.16, 95% CI [?1.63, ?0.68], P < 0.000 01). The study showed that the efficacy of experimental group in the treatment of AECOPD is better than control group. Due to the limitation of the number and quality of included studies, this conclusion needs more high quality studies to confirm.     

Meta‑analysis of Clinical Efficacy of Traditional Chinese Medicine in the Treatment of Aplastic Anemia

Background: The “Diagnosis and Treatment Guidelines for Chinese Medicine Internal Common Diseases” issued by the Chinese Institute of traditional Chinese medicine (TCM) offers many methods for the treatment of aplastic anemia (AA). However, there is a lack of corresponding evidence. Objective: The study aimed to evaluate the clinical efficacy of TCM in the treatment of AA, and provide evidence for the development of guidelines for the diagnosis and treatment of AA using TCM. Methods: Data of randomized or semi?randomized control trials of AA treatments with TCM were retrieved, and the selected literature was scored using the Jadad scale. The data were extracted, and RevMan 5.2.6 software was used for the meta?analysis. Results: Two studies on the treatment of AA using Liuwei Dihuang pills combined with compound Zaofan pill were included. The results of the meta?analysis showed that there were no statistically significant differences in the efficacy between Liuwei Dihuang pills combined with compound Zaofan pill and androgen in the treatment of AA (P = 0.65). However, there were less adverse reactions, including liver damage and the hirsutism of women, with the former than the latter (P < 0.05). Other studies on the treatment of AA with TCM did not include reports from clinical trials. Conclusion: TCM had a certain curative effect when used to treat AA. However, the quality of the literature is generally low, and the sample size is small, which makes the validation of the results poor. Further high?quality studies are needed to provide high?level evidence.     

Chinese Herbal Medicine for the Treatment of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome‑Associated Diarrhea: A Protocol for the Systematic Review and Meta‑Analysis of Randomized Clinical Trials

Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome (AIDS) as a usual symptom in people with human immunodeficiency virus (HIV) infection. While it is usually not fatal, it can influence patients’ quality of life seriously. It has shown to be efficacious and improves people’simmune statusto a certain extent to treat HIV/AIDS?related diarrhea on the basis ofsyndrome differentiation and treatment or Chinese herbs plus conventional treatment. Therefore, it may have a good application potential. Here, we outline a protocol for the systematic review of this health?care intervention, with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine (TCM) for patients who suffer from HIV/AIDS?associated diarrhea. Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included, in spite of publication status or language. The primary outcomes include diarrhea frequency and fecal character. The databases we will search as follows: China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Wanfang Data, China National Knowledge Infrastructure, PubMed and the CENTRAL in Cochrane Library. Two authors will respectively conduct the screening of trials, data extraction, and use the Cochrane risk of bias tool to assess the methodological quality. We will analyze the data and perform a meta-analysis if possible. We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS?associated diarrhea.     

Clinical Effect of Tripterygium Glycosides Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome Patients: A Systematic Review and Meta‑Analysis

The objective of this study is to evaluate the effectiveness and safety of Tripterygium glycosides combined with glucocorticoids for the treatment of refractory nephrotic syndrome (NS). Computer search of Chinese and English databases, including CNKI, VIP, Wan Fang Database, PubMed, Cochrane Library, Embase, and Sinomed, for randomized controlled trials (RCTs) of Tripterygium glycosides combined with glucocorticoids for refractory NS (RNS) was conducted. Meta?analysis was performed using RevMan5.3. Thirteen RCTs comprising 994 patients were included in the study. Tripterygium glycosides combined with glucocorticoids had a statistical significance on the effective rate (odds ratio [OR] =4.69, 95% confidence interval [CI] 3.29, 6.67, P < 0.00001), 24?h urine protein ( Weighted mean difference (MD) = ?0.57, 95% CI [?0.62, ?0.51], P < 0.00001), serum albumin (MD = 4.77,95% CI [4.30, 5.24], P < 0.00001), total serum protein (MD = 9.45, 95% CI [8.73, 10.17], P < 0.00001), urea nitrogen (MD = ?0.53, 95% CI [?0.90, ?0.17], P = 0.005), and serum creatinine (MD = ?8.45, 95% CI [?15.32, ?1.57], P = 0.02). There was no statisticalsignificance on adverse reactions(OR = 0.68, 95% CI [0.41, 1.12], P = 0.13). Tripterygium glycosides combined with glucocorticoids could improve clinical effective rate, reduce 24?h urine protein, improve serum albumin and total serum protein, and reduce urea nitrogen and serum creatinine levels in patients with RNS. However, the quality of the included literature is poor, and conclusion still needs further verification using larger samples and high?quality randomized, double?blind controlled trials.     

Traditional Chinese Herbal Medicine for Perimenopausal Depression of Chinese Women: A Meta‑analysis

Objective: The objective of this study is to evaluate the effectiveness and safety of traditional Chinese herbal medicine (TCHM) in treatment of perimenopausal depression (PD) in China. Methods: To identify randomized controlled trials, an electronic search has been conducted through databases as follows: PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese Biological Medicine Database, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, and WanFang Digital Periodicals Database. Methodological quality was evaluated by Cochrane Collaboration’s tool which is able to assess the risk of bias in Review Manager Software. What’s more, meta?analysis was performed by using Cochrane Collaboration’s RevMan 5.2 software, (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, and Denmark). Dichotomous data were analyzed by using relative risk (RR) and 95% confidence interval (CI). Continuous variables were analyzed using weighted mean differences (WMDs) and 95% CI. Subgroup analysis was performed by the type of medicine which was used in the experimental group. Results: This meta?analysis includes 11 randomized control trials with 818 patients. Compared to the control group (RR: 1.14, 95% CI: [1.03, 1.26], P = 0.009 and WMD: ?2.09, 95% CI: [ ?3.58, ?0.18]), the experimental group had a significant higher clinical efficacy rate and relatively lower Hamilton Depression Rating Scale (HAM?D) score. For clinical efficacy rate, the results varied depending on the detail treatment measures of the experimental group. In the experimental group with TCHM, no significant difference was observed (RR: 1.14, 95% CI: [0.97, 1.33]), while in the experimental group combined with western medicine, a significant difference in the clinical efficacy rate between the experimental group and control group showed up (RR: 1.15, 95% CI: [1.01, 1.32], P = 0.04). For the HAM?D score, subgroup analyses revealed that the pure TCHM therapy was not associated with significant HAM?D score reduction compared to the control group (WMD: ?2.48, 95% CI: [?6.00, 1.03], P = 0.17). However, in the experimental group where western medicine was added to, the HAM?D score decreased statistically compared to the control group (WMD: ?1.88, 95% CI: [?3.58, ?0.18], P = 0.03). There is no serious adverse event in both groups. Conclusions: Combination therapy of TCHM and western medicine is more effective in treating PD in terms of clinical efficacy rate. However, the results should be interpreted with caution due to the mediocre methodological quality of the included trials.     

Meta‑Analysis of Niaoduqing Granules Combined With RAAS System Blocker in the Treatment of Diabetic Nephropathy

To systematically evaluate the efficacy of urinary granules combined with RAAS system blockers in the treatment of diabetic nephropathy(DN). A meta-analysis of the data required in the literature in accordance with this study was performed using Rev Man 5.3 software. Fifteen randomized controlled trials were analyzed in the present study to evaluate the clinical effect of Niaoduqing-angiotensin converting enzyme inhibitors/angiotensin receptor blocker(ACEI/ARB) in DN patients. A total of 1063 patients were involved, including 538 patients receiving the combination treatment and 525 patients in the control group. The results showed that the clinical efficacy of Niaoduqing granule combined with ACEI/ARB was significantly better than of the control group(odds ratio = 2.92, 95% confidence interval [CI] 1.76–4.86). The treatment combined with Niaoduqing granule decreased the 24-h urinary protein quantitation(mean difference [MD] 0.71, 95% CI 0.28–1.14) and urine albumin excretion rate(UAER)(MD 41.13, 95% CI 26.66–55.59) levels. However, the combination group had no treatment advantage on reducing serumurea nitrogen(MD 0.86, 95% CI 0.05–1.68, P = 0.02) and fasting blood glucose(MD-0.03, 95% CI-0.15–0.09, P = 0.61). And there was no significance in adverse events between two groups(risk ratio = 2.34, 95% CI 0.69–7.95, P = 0.17). Niaoduqing granule-ACEI/ARB combination group maybe as safe as ACEI/ARB alone, and the combination played an advantage in improvement in total effective rate, reduction of 24-h urinary protein quantitation and UAER.     

The Effect of Hormones of the Hypothalamic‑pituitary‑target Gland Axes in a Kidney‑Yang Deficiency Syndrome Model

Kidney?yang deficiency syndrome (KYDS) is a diagnostic pattern in the traditional Chinese medicine. Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic?pituitary?target gland axes. The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid (hydrocortisone and corticosterone). Such a model showed symptoms such as exhaustion, body twists, cold limbs, lying crowded together, decreased rectal temperature, sexual dysfunction, decreased reaction speed, reduced spontaneous activity, hair loss, loss of appetite, and weight loss. Moreover, the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes, including adrenocorticotrophic hormone, CORT, CRH, thyroid-stimulating hormone, triiodothyronine, thyroxine, T, E2 , follicle?stimulating hormone, luteinizing hormone, and 17?OHCS.     

A Study on the Mechanism of Bruceine D in the Treatment of Non‑small Cell Lung Cancer H1299 Cells

Background: Non?small cell lung cancer (NSCLC) is considered one of the leading causes of cancer?related death. Despite the availability of drugsfor the treatment of NSCLC, the need for the development of novel agents with high efficiency and fewer adverse effectsremains unmet. The natural compound bruceine D (BD) is widely recognized for its notable anti?inflammatory, antiparasitic, and hypoglycemic activities. However, it is unclear whether BD can be used as a novel agent for NSCLC treatment. Materials and Methods: MTT and colony formation assays were used to assess the antiproliferative effect of BD on NSCLC cells. Wound healing and transwell assays were performed to determine the effect of BD on the migration and invasion of H1299 cells, respectively. Western blotting assay was used to detect the expression levels of proteins. Results:We demonstrated thatBD significantly inhibited the proliferation of H1299,A549, and H226 cells with respective IC50 values of 6.06 ± 0.52, 7.15 ± 0.90, and 7.21 ± 0.75 μM. In addition, BD suppressed colony formation of H1299 cells in a dose?dependent manner. Following treatment with BD, the migration and invasive capabilities of H1299 cells were significantly inhibited in a dose? and time?dependent manner. Moreover, the results of Western blotting demonstrated that BD treatment resulted in the upregulation of the protein expression of E?cadherin and downregulation of the expression of N?cadherin, twist, snail, integrin αv, integrin β4, matrix metalloproteinase-7, and β-catenin proteins. Conclusion: BD inhibits proliferation, migration, and invasion of NSCLC cells; therefore, BD may be considered for its potential in adjuvant therapy for NSCLC.     

Analysis of the Frequency of Clinical Acupoint Use Based on ‘Traditional Chinese Medical Acupuncture-moxibustion Information Databank'

The frequencies of use of 361 human acupoints in 74 academic journals of traditional Chinese medicine published between 1949 and 2010 are arranged in order using ‘Traditional Chinese Medical Acupuncturemoxibustion Information Databank'. The frequencies of use are divided into five grades: most frequent use, more frequent use, frequent use, less frequent use and infrequent use. The most frequently used acupoints and infrequently used acupoints are summarized and analyzed to help point selection for clinical acupuncture and selection of acupuncture research projects in the future.     

Metrological Analysis and Evaluation of Acupuncture-Moxibustion Treatment for Diarrhea in Modern Literature

目的回顾1957～2005年针灸文献,探索针灸治疗腹泻用穴和治疗方法的规律,以期为针灸标准化研究提供客观的、可靠的数据.方法根据《中国现代针灸信息数据库》数据,采用计量分析方法进行综合分析.结果针灸治疗腹泻足三里、天枢、神阙应用频次为最,也是最佳组穴.成人腹泻以慢性腹泻为主,多用灸法;小儿腹泻以急性为主,多用穴位贴敷、水针.结论针灸治疗腹泻,多以针刺、灸法为主,建议足三里、天枢为针灸治疗腹泻基础方,并可随症选穴.     

Clinical Observation on Treatment of Primary Trigeminal Neuralgia by Point Penetrating Injection plus Ear Pressing

目的探讨顽固性三叉神经痛的有效治法.方法采用透穴注射配合耳压治疗原发顽固性三叉神经痛28例,并与单纯针刺28例对照.结果观察组总有效率为96.4%,对照组总有效率为78.6%,透穴注射配合耳压治疗原发顽固性三叉神经痛总有效率与单纯针刺组差异明显(P＜0.05).结论运用透穴注射配合耳压是治疗原发顽固性三叉神经痛的有效方法.     

Efficacy of Traditional Chinese Medicine in the Treatment of Rash Caused by Epidermal Growth Factor Receptor Inhibitors: A Frequency Statistics and Meta‑Analysis

Objective: The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine (TCM) in the treatment of rash caused by epidermal growth factor receptor inhibitors (EGFRIs). Materials and Methods: Foreign language database (such as PubMed, Web of Science, Cochrane Library, EMBASE) and Chinese language database (such as China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals [VIP], Wangfang, CBM disc) were searched for all trials of TCM in the treatment of rash caused by EGFRIs until January of 2019. We also looked through the references of relevant studies to supplement additional trials. The SPSS 25.0 was used for statistics of TCM with high frequency, and Review Manager 5.3 was used for meta-analysis. Results: A total of 22 studies were included in the study. We selected TCM whose frequency were >3.0%. They were Lonicera japonica（金银花）, Licorice Roots Northwest Origin（生甘草）, Cortex Dictamni（白鲜皮）, Radix Sophorae Flavescentis（苦参）, Schizonepeta（荆芥）, Saposhnikovia Divaricate（防风）. The meta?analysis revealed that the efficacy of TCM in treating EGFRIs?related rash was better than that of Western medicine or none. Conclusions: TCM could significantly relieve rash caused by EGFRIs, which is worth popularizing. Moreover, the mechanism deserves to be further explored.     

QIU Chang-lin＇s Experience in the Differential Treatment of Senile Dementia Based on Phlegm

Senile dementia refers to the various dementia syndromes occurring in the geratic period, including Alzheimer＇s dementia （AD）, vascular dementia （VD）, and mixed type dementia. It is mainly manifested by disturbance of intelligence and cognition, which falls into the TCM category of ＇dementia＇, ＇idiocy＇, ＇amnesia＇, and ＇melancholia＇. At present, this disease is considered by TCM differentiation to be excess in superficiality and deficiency in origin, and should be treated for clearing away pathogens and strengthening the body resistance at the same time. Having engaged in TCM clinical practice for more than 40 years, Dr. QIU Chang-lin has treated this disease based on the differentiation of phlegm, and obtained marked clinical therapeutic effects.     

Simultaneous Determination of Six Compounds in Rat Plasma by Ultra‑Performance Liquid Chromatography with Tandem Mass Spectrometry: Application in the Pharmacokinetic Study of Qing Gan‑Shu Yu‑Fang

A rapid and high selective ultra?performance liquid chromatography (UPLC) with tandem mass spectrometry method for simultaneous determination of six compounds including albiflorin, paeoniflorin, picroside I, picroside II, saikosaponin A, and saikosaponin D in rat plasma was developed and validated using butyl p-hydroxybenzoate as an internal standard. One-step direct protein precipitation with acetonitrile was used to extract the compounds from the rat plasma samples. Chromatographic separation was achieved using an ACQUITY UPLC BEH C18 column (100 mm × 2.1 mm, 1.7 µm) at a flow rate of 0.4 mL/min, using gradient mode containing 0.1% formic acid in water and acetonitrile were used as the Mobile phase A and B. Electrospray ionization in negative ion mode and multiple reaction monitoring were used to identify and quantify active components. Calibration curves showed good linearity (R2 > 0.9908) over a wide concentration range for all compounds. The intra- and interday precision (relative standard deviation) ranged 2.4%–7.0% and 2.6%–8.0%, respectively. The accuracy (relative error) was from ?13.0% to 13.2% at all quality control levels. The recovery ranged from 81.1% to 92.5%. The validated method was successfully applied to pharmacokinetic study in rats after oral administration of Qing Gan?Shu Yu?Fang. The results show that one can draw a conclusion that these six active ingredients can be quickly absorbed and play a pharmacodynamic role rapidly in vivo.     

Clinical Observations on the Treatment of Migraine by Acupuncture plus Auricular Plaster Therapy

目的探讨针刺配合耳压辨证治疗偏头痛的临床疗效.方法将150例偏头痛患者随机分为观察组(n=90)和对照组(n=60).观察组患者采用针刺配合耳压辨证治疗,对照组患者采用口服西比灵治疗,并将两组的治疗效果进行对比观察.结果观察组总有效率为94.4%,好于对照组(73.3%),观察组痊愈率为87.8%,高于对照组(55.0%).两组差异有非常显著意义(P＜0.01).结论观察组疗效明显优于对照组,运用针刺配合耳压辨证治疗偏头痛,能获得良好的临床疗效.     

Systematic Evaluation(Meta-analysis)of the Efficacy and Safety of Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)in the Treatment of Suppurutive Tonsillitis in Children

To systematically evaluate the efficacy and safety of Pudilan Xiaoyan Oral in Liquid(蒲地蓝消炎口服液)in the treatment of suppurative tonsillitis in children.In WanFang,CNKI,VIP,CBM,PubMed,Embase and Corchrane and other databases,relevant literatures about Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)in the treatment of pediatric suppurative tonsillitis were searched.The retrieval time was from the establishment of the database to April 2019.Relevant randomized controlled trials were extracted.The control group was treated with conventional antibiotics,and the observation group was treated with Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)based on the control group.After they were summarized and analyzed,Cochrane Handbook 5.1 evaluation standard and RevMan 5.3 software were used to determine the quality of literature.A total of 172 literatures were retrieved and 23 randomized controlled trials were included.A total of 1188 children were in the experimental group while 1175 children were in the control group,involving 2363 children with suppurative tonsillitis.Meta-analysis showed that the total effective rate of Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment was better than that of routine treatment(RR=0.88,95%CI(0.86,0.91),P<0.00001);Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment in children was better than that of routine treatment alone in term of temperature recovery,sore throat time,the reduction of tonsil purulent secretion.There were few reports of adverse reactions and no serious adverse reactions.To sum up,Pudilan Xiaoyan Oral Liquid(蒲地蓝消炎口服液)combined with routine treatment can significantly improve the efficacy of children with suppurative tonsillitis,but due to the low quality of the included literature,it should be used cautiously.It is suggested that clinical randomized controlled trials should be designed with large sample size,multi-centers and conforming to international standards to improve the quality of evidence.     

Clinical Research Progress of Dachengqi Decoction (大承气汤) in the Treatment of Intestinal Obstruction

综述大承气汤治疗肠梗阻的研究概况.临床采用大承气汤治疗肠梗阻,多以该方为基础方进行加减,兼补气、行气、活血、滋阴、清热等.大承气汤口服、胃管注入、保留灌肠、直肠滴入、肠梗阻导管等给药方式可单独应用或多种给药方式联用,亦可联合针灸、按摩、外敷等中医特色疗法,以加强临床疗效.