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.     

Efficacy and safety of puerarin injection in treatment of diabetic peripheral neuropathy： a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE： To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of diabeticperi pheral neuropathy（DPN）.METHODS： Randomized controlled trials investigating the efficacy of puerarin injection on DPN were searched for in China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, and Cochrane Library from establishment to April 30.Two reviewers independently retrieved and extracted the information.The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.2 software.RESULTS： Twenty-two studies involving 1664 participants were included. The quality of the studies was found to be relatively low. Meta-analysis showed that puerarin injection combined with western medication was more effective than conventional therapy for rate, nerve conduction velocity（NCV）, and hemorheology index. Six adverse drug reactions（ADRs） from puerarin injection were reported in two studies. Reactions included facial flushing, palpitations, and pain at infusion locations. However,noserious ADRs were reported.CONCLUSION： Puerarin injection was effective for the treatment of DPN. Puerarin can improve the total effective rate, correct NCV that was decreased by diabetes, and improve the hemorheology index.Puerarin was also relatively safe clinically. However,since the articles included in the study were not high-quality, more studies should be conducted to strengthen their findings.     

Case-based learning in education of Traditional Chinese Medicine： a systematic review

OBJECTIVE： To assess the effect of case-based learning（CBL） in the education of Traditional Chinese Medicine（TCM）.METHODS： The studies concerning TCM courses designed with CBL were included by searching the databases of EBSCO, Pubmed, Science Citation Index, China National Knowledge Infrastructure,Chongqing VIP database. The valid data was extracted in accordance with the included criteria.The quality of the studies was assessed with Gemma Flores-Masteo.RESULTS： A total of 22 articles were retrieved that met the selection criteria： one was of high quality;two were of low quality; the rest were categorized as moderate quality. The majority of the studiesdemonstrated the better effect produced by CBL,while a few studies showed no difference, compared with the didactic format. All included studies confirmed the favorable effect on learners＇ attitude,skills and ability.CONCLUSION： CBL showed the desirable results in achieving the goal of learning. Compared to didactic approach, it played a more active role in promoting students＇ competency. Since the quality of the articles on which the study was based was not so high, the findings still need further research to become substantiated     

Randomized Clinical Trials of Traditional Chinese Medicines for Treating Ulcerative Colitis: A Scoping Review

Objective: Traditional Chinese medicines (TCMs) are efficacious against ulcerative colitis (UC). In recent years, the number of randomized clinical trials (RCTs) of TCM has increased. Thus, it is very important to summarize the basic characteristics, quality, and types of TCM interventions in published RCTs. This scoping review was performed to systematically identify and describe the current situations about RCTs of TCMs for treating UC. Hope to express the focus and specifics of nowadays research in TCM interventions in RCTs and evaluate their common disadvantages exposed to help advance in TCM researching. Materials and Methods: Ascoping review was conducted according to the PRISMA extension for scoping reviews. We searched two English databases and four Chinese databases from the date of establishment of each database to January 2020. Data from RCTs focusing on any TCM treatment for patients with UC were extracted and evaluated. Selection and characterization were performed by two independent reviewers using predefined forms. All discrepancies were resolved by consensus discussion with a third reviewer. Microsoft Excel 2010 was used to extract the following data from the included studies: (1) basic information of the included studies including research ID, article title, publication language, journal, year of publication, and funding information; (2) patient information including gender, age, disease course, disease stage, severity, sample size; and (3) information on intervention measures, types of intervention measures, drug dosage forms, and treatment courses. Results: The search identified 2225 RCTs published between 1987 and 2020. These studies covered 36 provinces in China. The time frame of the RCTs was <28 days in approximately one-third of the RCTs (647, 29.08%). Only one RCT was published in English. Nearly three-quarters of RCTs (1665, 74.83%) did not report the severity of the disease. Three types of interventions were included in the RCTs: pharmacotherapy (2028, 91.15%), nonpharmacotherapy (57, 2.56%), and a combination of the two (140, 6.29%). The administration modes of the intervention groups were evaluated. Drug therapy involved 12 types of TCM dosage forms, which were decoctions, troches, powders, capsules, granules, pills, suppositories, ointments, injections, gels, oral liquids, and substitute tea according to the frequency of use. Nondrug intervention measures involved 10 treatment options, namely, acupuncture, moxibustion, hemospasia, auricular point, acupoint catgut embedding, acupoint injection, scrapping, tuina, acupoint application, and five?tone therapy according to the frequency of use. Most studies included in this review were low in quality. This underscores the need for improvement in the quality of trial methodology in TCM RCTs.     

Current status of outcome reporting in randomized controlled trials of traditional Chinese medicine for mammary gland hyperplasia: A systematic reviewOA

Objective: To assess outcome indicators in clinical trials and provide a reference for establishing a core outcome set to treat hyperplasia of mammary gland(HMG) with traditional Chinese medicine(TCM).Methods: Eight online databases were searched from their inception to December 31, 2022, to assess outcomes reported in randomized controlled trials(RCTs) of HMG treated with TCM. The quality of the included studies was assessed according to the Cochrane Risk of Bias Assessment Tool. All outcomes w...     

Xuefuzhuyu decoction for hyperlipidemia： a systematic review and Meta-analysis of randomized clinical trails

OBJECTIVE：To evaluate the efficacy and safety of Xuefuzhuyu decoction for hyperlipidemia.METHODS：Randomized clinical trials on hyperlipidemia treated by Xuefuzhuyu decoction,either alone or with Western Medicine,were searched in electronic databases.Databases searched were：MEDLINE,Allied and Complementary Medicine Database,EMBASE,The Cochrane Library 2013（Issue4）,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,and Wanfang Database up to 2 May,2013.Study selection,data extraction,quality assessment,and data analysis were conducted according to the Cochranestandards.RESULTS：Six randomized clinical trials involving748 patients（373 patients in the treatment group,375 patients in the control group）were included in the analysis.The studies were of low methodological quality.Meta-analysis indicated that the effect of Xuefuzhuyu decoction on hyperlipidemia was better than that in the control group[n=748,OR=5.07,95%CI（3.40,7.58）,P〈0.01].Weighted mean differencesin total cholesterol,low-densitylipoprotein cholesterol,triglycerides,and high-density lipoprotein cholesterol were﹣0.79,﹣0.74,﹣0.44,0.16,respectively,and Meta-analysis revealed that the treatment group was better than the control group with 95%CI（﹣1.21,﹣0.36）,（﹣0.94,﹣0.55）,（﹣0.77,﹣0.11）,（0.04,0.27）,respectively（all P〈0.05）.Some adverse events in evaluated studies wererecorded.CONCLUSION：Xuefuzhuyu decoction may be effective for treating hyperlipidemia.The studies we analyzed were of low methodological quality,which indicates that the above findings should be considered cautiously.Therefore,more strictly designed large-scale randomized clinical trials are needed to evaluate the efficacy of Xuefuzhuyu decoction in hyperlipidemia.     

Blinding Effect of Non-penetrating Sham Needle in the Randomized Controlled Trials of Acupuncture: A Systematic Review简

The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials（RCTs） of acupuncture taking non-penetrating sham acupuncture as placebo needle. Systematic searches were conducted in 13 electronic databases up to July 2012： Medline, PubMed, the Cochrane Library, CINAHL, EMBASE, a Chinese medical database. All parallel or cross-over RCTs of acupuncture for the blinding effect of non-penetrating needle were chosen without language restrictions. Finally, totally 7 RCTs met the inclusion criteria. In conclusion, our systematic review and meta-analysis demonstrate that the non-penetrating needle is an effective instrument for placebo control in the acupuncture RCTs.     

Clinical Observation on Combination of Acupuncture and Medication in Treating Breast Hyperplasia简

Objective： To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods： One hundred patients with breast hyperplasia who met the inclusion criteria were randomly divided into an acupuncture combined with traditional Chinese medicine（A＆TCM） group and a traditional Chinese medicine（TCM） group, 50 cases in each group. The A＆TCM group received acupuncture combined with oral TCM; the TCM group only received oral TCM. After two courses of treatment, the efficacy was observed. Results： During the two treatment courses, the recovery rates had been increasing in both groups. The recovery rate of the A＆TCM group was 40.0% and the total effective rate was 98.0%. While the recovery rate of the TCM group was 18.0% and the total effective rate was 80.0%. According to statistical analysis, the differences of recovery rate and total effective rate between the two groups were statistically significant（P〈0.01）. Conclusion： Combination of acupuncture and TCM is more effective than simple oral TCM.     

Effect of traditional Chinese medicine on anthracycline-induced cardiotoxicity in animal models:A systematic review and metaanalysis

Objective:To evaluate the effect of traditional Chinese medicine(TCM)on anthracycline-induced cardiotoxicity(AIC)in animal models.Methods:Separate systematic searches for preclinical studies were performed in the PubMed,EMBASE,Web of Science,Chinese National Knowledge Infrastructure,Chinese Biomedical Database,Chinese Scientific Journal Database,and Wanfang Data from inception to August 2019.The primary outcomes were echocardiography,serum assays for myocardial enzymograms,histological assessments,and electrocardiograms.The secondary outcomes mainly included body weight and safety evaluations.The protocol is registered on PROSPERO(CRD42019145819).RevMan(V.5.3)was used for meta-analysis.Results:We identified 10 studies from 9 international scientific publications describing the efficacy of TCM on AIC animal models.All the included studies reported that,compared with animal model without any intervention,TCM significantly improved ventricular function,cardiac biomarkers,electrocardiograph results,and cardiac fibrosis.Improved survival rates and body mass indices were also observed with TCM.We further pooled the available data from four studies(63 animals)for the meta-analysis and the results showed that,compared with models without any intervention,TCM significantly increased the ejection fraction by 14.13%(95%CI,9.96e18.29)and fraction shortening by 8.66%(95%CI,6.05 e11.26).Creatine kinase-MB(SMD=2.49,95%CI:-3.12 to-1.85)and lactate dehydrogenase(SMD=-2.78,95%CI:-3.45 to-2.12)were also significantly decreased by TCM.Conclusions:TCM is effective in improving AIC in animal models and has tremendous potential to be translated to treat AIC in clinical practice.Additionally,the systematic review and meta-analysis of animal experiments may be valuable in enhancing and guiding animal experiments and promoting the transformation of the results.     

Randomized Clinical Trials of Constitutional Acupuncture： A Systematic Review

The aim of this systematic review is to compile and critically evaluate the evidence from randomized clinical trials （RCTs） for the effectiveness of acupuncture using constitutional medicine compared to standard acupuncture. Ten databases were searched through to December 2008 without language restrictions. We also hand-searched nine Korean journals of oriental medicine. We included prospective RCTs of any form of acupuncture with or without electrical stimulation. The included trials had to investigate constitutional medicine. There were no restrictions on population characteristics. Forty-one relevant studies were identified, and three RCTs were included. The methodological quality of the trials was variable.     

Effect of Traditional Chinese Medicine on oligoasthenospermatism： a narrative review

OBJECTIVE： To summarize the treatment of oligoasthenospermatism（OAS） with Traditional Chinese Medicine（TCM）.METHODS： The literature describing OAS treatment with TCM in the past 4 years was searched.Three studies were reviewed, evaluated, and summarized. The etiology and pathogenesis, pattern differentiation, medicine administration, and combination of TCM with Western Medicine were all examined.RESULTS： TCM had an advantage in treating OAS and had fewer adverse events than conventional treatments.CONCLUSION： Although TCM has an advantage in treating OAS and fewer adverse events, the efficacy of TCM and modern medicine on OAS is unsatisfactory.     

Clinical efficacy and safety of Traditional Chinese Medicine combined with Western Medicine in patients with diabetic acute ischemic stroke

OBJECTIVE： To observe the clinical efficacy and safety of Traditional Chinese Medicine （TCM） com- bined with Western Medicine （WM） in patients with diabetic acute ischemic stroke. METHODS： Ninety patients with diabetic acute ischemic stroke were randomly divided into a treat- ment group and a control group. The 45 patients in the treatment group were given standardized treat- ment with TCM combined with WM. They received corresponding oral Chinese decoctions three times daily, according to their TCM syndromes, along with basic western medical treatment. The 45 patients in the control group were given non-stan- dardized treatment with TCM combined with WM. They received an oral Chinese decoction for promo- tion of blood circulation to inhibit hemostasis, regardless of their TCM syndromes, along with ba- sic western medical treatment. The treatments lasted for 4 weeks. Scores were evaluated on the National Institutes of Health Stroke Scale （NIHSS） score, activity of daily life （ADL） scores, and TCM symptoms before treatment and 2 and 4 weeks after treatment. RESULTS： Analysis of variance for repeated mea- surements showed that there were significant dif- ferences in NIHSS and ADL score before and after treatment in both groups （P〈0.05）. There were also significant differences between the scores at 2 and 4 weeks after treatment. There were signifi- cant differences in TCM syndrome scores before and after treatment in both groups （P〈0.05）. There were also significant differences between the scores at 2 and 4 weeks after treatment. The X2 test showed no statistically significant difference in the incidence of adverse reactions between the two groups （P〉0.05）. CONCLUSION： Standardized treatment was supe- rior to non-standardized treatment for clinical efficacy of TCM combined with WM in patients with diabetic acute ischemic stroke, and the superiority was more obvious in improving neural dysfunction, ADL score, and TCM symptoms. The adverse reactions were similar in the two treatment groups.     

Treatment of constipation-predominant irritable bowel syndrome by focusing on the liver in terms of Traditional Chinese Medicine： a meta-analysis

OBJECTIVE：To assess the efficacy of Traditional Chinese Medicine（TCM）on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS：Databases（domestic and foreign）were searched with the key words＂irritable bowelsyndrome＂,＂constipation＂,and＂Chinese medicine＂;the relevant articles were retrieved and evaluated.Cure rate,＂remarkable efficacy＂,recurrence rate and the incidence of adverse reactions were the outcome indicators.Review Manager ver 5.1 was used for this meta-analysis,and funnel plots used to detect publication bias.RESULTS：Nineteen randomized controlled trials were included and 1510 patients involved.The treatment guided byTCM based on the liver was superior to Western Medicine[odds ratio（OR）=2.46,95%confidence interval（CI）1.80,3.35）],cure rate[OR=2.61,95%CI（1.93,3.52）],remarkable efficacy[OR=2.68,95%CI（1.82,3.95）],recurrence rate[OR=0.19,95%CI（0.12,0.29）]and the incidence of adverse reactions[OR=0.24,95%CI（0.09,0.65）].However,funnel plots showed publication bias.CONCLUSION：Compared with Western Medicine,the treatment of IBS-C based on the liver is significantly better but the results must be treated with caution because publication bias was recorded.     

Network Pharmacology for Traditional Chinese Medicine Research: Methodologies and Applications

The inception of network pharmacology comes from the advance in "multi-target, multi-drug" paradigm and opens up a new field for pharmaceutical science. Traditional Chinese medicine(TCM) is well-known for its use of medicinal herb combinations to treat the functional disorders induced by diseases through a holistic view, which naturally followed the principal of network pharmacology. In this review, the methodologies of network pharmacology in TCM studies were summarized. Specifically, the methodologies for network construction and network analysis were discussed in detail by following several TCM study cases. The perspectives for TCM network pharmacology were also provided.     

Diagnosis and objective pain assessment of traditional Chinese medicine may be useful to demonstrate specific effects of acupuncture in low back pain: A prospective, randomized, controlled and single blinded pre-study

Objective： To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagnoses of both Western medicine and traditional Chinese medicine （TCM） were used as inclusion criteria to allocate acupoints more precisely to the complaints of the patients. Secondly, objectively measurable parameters of pain relief in addition to usual Visual Analogue Scale （VAS） were chosen to quantify the effects of acupuncture. Methods： The study was prospective, randomized, controlled and single-blinded. Eighteen patients with chronic back pain and TCM diagnosis of a Taiyang/Yangming syndrome received one single session of acupuncture chosen according to TCM diagnosis or acupuncture on points outside the meridian system （controls）. We evaluated pain via VAS and increased mobility via inclinometry of the back. Results： Although the sample size was small, there was a statistically significant improvement in pain and mobility in the intervention group （n=13）, but not in the control group （n=5）. The calculated sample size adequate power was lower for inclinometry than for VAS, indicating that VAS is less probable to discriminate acupuncture effects. Conclusion： Objectively measurable physical parameters such as the angle of flexion before and after acupuncture （inclinometry） may be more suitable to measure pain relief than subjective assessment by VAS in acupuncture studies. TCM diagnosis may be a helpful inclusion criterion in studies on acupuncture, so as to potentially allocate interventions better to the complaints of patients.     

Systematic Review and Meta-Analysis of Hugan Tablets(护肝片)in the Treatment of Drug-Induced Liver Injury

Objective:To systematically evaluate the efficacy and safety of Hugan Tablets(护肝片)in the treatment of drug-induced liver injury.Methods:Totally seven Chinese and English databases,including CNKI,Wanfang,VIP,CBM,PubMed,EMbase,Web of Science were searched for randomized controlled trials(RCTs)of Hugan Tablets(护肝片)for the treatment of drug-induced liver injury,which were published from the date of establishment to April 20,2019.The meta-analysis software RevMan 5.3 software and Excel were used to build a database into combine and analyze the studies that met the standards and to draw a forest plot.Results:Forty five RCTs were included with 7478 patients.The quality of included studies was uneven.Meta-analysis showed that the outcome index of liver injury rate was divided into seven subgroups.Hugan Tablets(护肝片)were used in the treatment of anti-tuberculosis drugs was superior to the conventional western medicine treatment group(RR=0.27,95%CI[0.22,0.33],P<0.00001).Which was also better than the without Hugan Tablets(护肝片)treatment group(RR=0.32,95%CI[0.20,0.52],P<0.00001).For the role of drug-induced liver injury in the treatment of type 2 diabetes,the Hugan Tablet+conventional treatment group is better than the conventional treatment group(RR=0.16,95%CI[0.03,0.88],P=0.03).The effect of drug-induced liver injury in the treatment of hypertension was superior to the conventional western medicine treatment group(RR=0.07,95%CI[0.03,0.14],P<0.00001).The effect of drug-induced liver injury during the treatment of hyperlipidemia was not statistically significant(RR=0.57,95%CI[0.33,1.00],P=0.05).There was no statistical difference between the two groups in the effect of drug-induced liver injury during the treatment of coronary heart disease(RR=0.09,95%CI[0.01,1.61],P=0.10).There was no significant difference between the two groups in the treatment of cerebral thrombosis for drug-induced liver injury(RR=0.11,95%CI[0.01,2.01],P=0.14).The effect of anti-hyperthyroidism on liver injury was better than that of conventional western medicine treatment group(RR=0.45,95%CI[0.25,0.82],P=0.009).Outcome index of total effective rate was divided into two subgroups.The effect of drug-induced liver injury caused by the type of drug was not mentioned was superior to the conventional western medicine treatment group(RR=0.78,95%CI[0.70,0.88],P<0.0001).There was no significant difference between the two groups in the liver injury caused by antipsychotic drugs(RR=0.97,95%CI[0.81,1.16],P=0.72).Conclusion:When used in the treatment of tuberculosis and psychiatric drug treatment,combineduse of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver damage,and can significantly improve clinical symptoms caused by liver damage.In the treatment of hypertension,the addition of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver injury,improving the safety of medication.In the treatment of drug-induced liver injury caused by which drug is not mentioned,Hugan Tablet has a therapeutic effect.Slight adverse reactions were reported,including rash,headache,palpitations,hypoglycemia,flushing,fatigue,nausea,bowel sounds,flatulence,diarrhea,and gastrointestinal discomfort.All studies reported minor adverse reactions that were well tolerated by patients and recovered without treatment after discontinuation.Oral administration of Hugan Tablets(护肝片)has positive effects on druginduced liver injury,but this conclusion still needs further evidences delete.It is necessary to adopt a larger sample,more design,and accord with the international standards to improve the quality of evidence.     

针灸治疗湿疹的系统评价

Objective To analyze the efficacy and safety of acupuncture treatment on eczema for providing the objective and reliable evaluation.Methods Cochrane systematic review methods were adopted.The author searched data in the VIP database(1987～2009),Qing Hua Tong Fang database(1997～2009),and China Academic Journals' Full-text Database(CNKJ)(1997～2009)concerned on acupuncture treatment of eczema and evaluated by RCT. Odds ratio(OR) and 95%confidence interval(95%C1)were used as the statistic efficacy for analysis.The quality of the papers was analyzed according to the four quality evaluation criteria in Cochrane Handbook and then meta-analysis(Meta)by RevMan4.2.2 software.Results There were 19 relevant Papers of randomized controlled trials(RCT)and non-randomized controlled trial (CCT)met the included criteria Meta analysis showed that there were statistically significant difference between acupuncture and conventional treatment of eczema.Conclusion Acupuncture treatment can improve the efficiency and reduce the recurrence rate of eczema.However,due to relatively low methodological trial adopted in these included papers,more scientific clinical trial designs were expected for provided high quality papers used for statistical analysis.     

针灸治疗湿疹的系统评价

Objective To analyze the efficacy and safety of acupuncture treatment on eczema for providing the objective and reliable evaluation.Methods Cochrane systematic review methods were adopted.The author searched data in the VIP database(1987～2009),Qing Hua Tong Fang database(1997～2009),and China Academic Journals' Full-text Database(CNKJ)(1997～2009)concerned on acupuncture treatment of eczema and evaluated by RCT. Odds ratio(OR) and 95%confidence interval(95%C1)were used as the statistic efficacy for analysis.The quality of the papers was analyzed according to the four quality evaluation criteria in Cochrane Handbook and then meta-analysis(Meta)by RevMan4.2.2 software.Results There were 19 relevant Papers of randomized controlled trials(RCT)and non-randomized controlled trial (CCT)met the included criteria Meta analysis showed that there were statistically significant difference between acupuncture and conventional treatment of eczema.Conclusion Acupuncture treatment can improve the efficiency and reduce the recurrence rate of eczema.However,due to relatively low methodological trial adopted in these included papers,more scientific clinical trial designs were expected for provided high quality papers used for statistical analysis.     

Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke： a systematic review and meta-analy- sis

OBJECTIVE： To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke. METHODS： Randomized controlled trials （RCTs） testing ligustrazine in the treatment of acute isch- emic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medi- cal Journal Database, Chinese Biomedical Data- base, China National Knowledge Infrastructure Da- tabase, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Co- chrane Handbook 5.1, a risk of bias assessment toot. RevMan 5.1 was used for meta-analysis.RESULTS： Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR=0.42, 95% CI （0.18, 0.94）, P〈 0.05] or 3-years observation [RR=0.48, 95% C/（0.27, 0.83）, P〈0.05]. The ligustrazine group also showed higher survival rate [RR=1.67, 95% CI （1.02, 0.2.71）, P〈0.05] and significantly better effective rate [RR= 1.28, 95% CI（1.10, 1.50）, P〈0.05] than that of the control group at the end of 1 year visit. Only one tri- al conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor. CONCLUSION： The findings provided evidence that the combination of ligustrazine and conven- tional medication was medium- and long-term ben- eficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.     

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

OBJECTIVE： To establish a quantification model of Traditional Chinese Medicine（TCM） syndromes by sampling patients undergoing idiopathic precocious puberty（IPP） and early puberty.METHODS： A questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model ofTCM syndromes.RESULTS： We found that precocious puberty had 3types of syndrome, including hyperactivity of fire due to Yin deficiency（Syndrome I）, depressed liver Qi transforming into fire（Syndrome II）, and end retention of damp heat（Syndrome III）. In the IPP group, Syndrome I was the most common principal syndrome（100%）. Forty-six patients（43.81%） werediagnosed with Syndrome I accompanied by Syndrome II and 11（10.48%） were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome（98.39%）. The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation（62.86% prevalence） in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient（ANC） method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis.CONCLUSION： We find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I（hyperactivity of fire due to Yin deficiency） is the main syndrome in the two groups. ANC may be an appropriate for quantification model ofTCM syndromes.