Integrative medicine: A characteristic china model for cancer treatment

Integrative medicine(IM) has attracted increasing attention of the experts and patients around the world.Chinese medicine(CM),as the important part of IM,has played an important role in the treatment of cancer.CM is practiced side by side with Western medicine in many of China’s hospitals and clinics.On the basis of the review of the clinical practices and basic researches these years,we introduce the current situation and progress in integrative oncology in China,and show the main feature of CM approach in the cancer treatment.Furthermore,we also discuss the main problems limiting the progress of CM,and point out international collaboration will provide new opportunity to promote the development of IM in China.     

Chinese ethics review system and chinese medicine ethical review: Past, present, and future

The Chinese medical ethics committee and the ethical review system have made the following achievements:(1) enabled the institutionalization of medical ethics,(2) carried out the ethics review of Chinese medicine(CM) and integrative medicine extensively,(3) trained a large number of ethical professionals, (4) supported and protected the interests of patients and subjects,and(5) ensured the correct direction of biological research and provided ethical defense for the publication of its results.However,at the same time, they are also faced with some new problems and difficulties that need to be resolved in the following ways:(1) to refine the relevant rules of ethical review,(2) to develop the relevant standards of the CM and integrative medicine ethical review,(3) to enhance the independence and authority of ethics committee,(4) to emphasize innovation and to discover and solve new problems,and(5) to increase international exchanges and improve relevant research.     

Intestinal Microecology: An Important Target for Chinese Medicine Treatment of Non-alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases worldwide, causing serious economic and medical burdens. Currently, Chinese medicine (CM) has become an important means in treating NAFLD in China. Intestinal microecology (IM) is an important part of the internal environment in the human body and is involved in the occurrence and development of NAFLD. In this paper, the authors systematically discuss the significance of IM in the pathogenesis of NAFLD and the current status of research on the CM treatment of NAFLD via IM regulation. In combination with our own research practice, we propose that IM is an important target for the treatment of NAFLD with CM and formulate plans for future research to target limitations existing in current studies.     

Comprehensive Treatment with Chinese Medicine in Patients with Advanced Non-Small Cell Lung Cancer: A Multicenter, Prospective, Cohort Study

Objective: To determine whether additional Chinese medicine(CM) could prolong survival and improve the quality of life(QOL) in patients with advanced non-small cell lung cancer(NSCLC) compared with Western medicine(WM) alone. Methods: This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage Ⅲ–Ⅳ NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network(NCCN) guidelines. In the integrative medicine(IM) group, individualized CM(Chinese patent medicines and injections) and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months. Results: The median survival was 16.60 months in the IM group and 13.13 months in the WM group(P0.01). The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group(P0.05). The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course(P0.05). Conclusions: Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio-and chemotherapy may be attenuated as CM is used in combination with conventional treatments.     

Principles of ethics review on traditional medicine and the practice of institute review board in China

As one of the significant parts of medical science research in China,the research on Chinese medicine(CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture.Therefore,in the practice of ethics review on CM research protocols,besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study,we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values.In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics,and then attempted to summarize the key points for the bioethics review to CM researches in China,so as to serve as reference for the bioethics review to traditional and alternative medicine researches.     

Different Survival Benefits of Chinese Medicine for Pancreatic Cancer: How to Choose?

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.     

New Developments in the Pharmacodynamics and Pharmacokinetics of Combination of Chinese Medicine and Western Medicine

It is very common to use Chinese medicine (CM) combined with Western medicine (WM) in clinical practice. The appropriate combination of CM with WM can reduce toxicity and enhance effects in order to make the best use of advantages and bypass the disadvantages. However, an inappropriate combination can not only affect the curative effect but even cause death. Therefore, strengthening the complementary advantages of the CM and WM to improve the therapeutic efficacy and reduce side effects has become an important research topic of clinical medicine and pharmacy. Many researchers try to clarify the effects of combining CM with WM on therapeutic efficacy and absorption, distribution, metabolism and excretion by pharmacodynamics and pharmacokinetics studies, providing evidence for clinical application. This review focuses on the new developments in the pharmacodynamics and pharmacokinetics of the combination of CM with WM in order to give references for clinical treatment.     

A Reflection on the 2017 Nobel Prize for Physiology and Chinese Medicine

Research on the molecular mechanisms controlling circadian rhythm in Western medicine is comparable to the study of a day-night rhythm in Chinese medicine (CM), as also focus on the same life phenomenon. By comparing the two, this paper elaborates on the differences between them in their respective issues of consciousness, ways of thinking, research methods and research results. Relatively speaking, Nobel Prize research has a stronger sense of the problems and concerns about the essence of "what", while CM focuses on "how a thing functions". The former mainly adopts experimental and mathematical methods, while the latter primarily depends on observation and understanding. The natural philosophy and natural science eventually lead to the results and the inevitable, quantitative and qualitative differences. Research on the life rhythm in CM should be proposed, scientific problems should be fully grasped, and research should be carried out with the aid of multidisciplinary new knowledge and new achievements through cross-disciplinary studies. On the basis of clinical epidemiological research and experimental research, a systematic review should be made of the human physiology of CM and the pathological rhythm model to explore the regulatory mechanism of time rhythm and create a new theory of time medicine.     

Roles and Implications of Paper Media in Early Stage of Integration of Traditional Chinese Medicine and Western Medicine in China

Paper media including the People''s Daily, Guangming Daily, Health News and Journal of Traditional Chinese Medicine were the main media that spread the thought and policy of integrative medicine (IM) in the early stage of the integration of traditional Chinese medicine (TCM) and Western medicine (WM) in China. Issues including paper media and its roles for spreading IM, from "TCM learning from WM" to "WM learning from TCM", advocating integration of TCM and WM, promoting IM through multiple channels were analyzed in this article, so as to show the propagation process of IM in China and the roles of the paper media. It was shown that strengthening the propaganda of IM through mainstream media, strengthening media convergence and the role of new media are important in spreading the thought of IM.     

中医和中西医结合临床指南制定的现状与问题

随着临床循证指南的广泛应用及中医药规范化工作的开展,各类中医或中西医临床指南也在逐渐增多。借助指南质量评估工具对2008年10月前公开发表的11个中医和中西医结合临床指南进行初步评价,大部分指南未描述证据收集和综合证据的方法,仅1篇说明推荐意见的证据分级标准,存在指南制作不够规范,编写人员专业背景单一,缺乏高级别的证据等问题。建议成立多学科组成的指南制定小组,注重证据并严格遵循循证指南制订的原则和流程,建立符合中医文献自身特点的证据评价和分级方法,注重中医指南的适用性与指导性,并加强对指南质量的评估。     

Chinese Medicine as Complementary Therapy for Female Infertility

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.     

类风湿关节炎寒热属性分类及其对中西药疗效的影响

目的:探讨类风湿关节炎(RA)患者寒热属性分类规律及其对中、西药疗效的影响。方法:397例来自多中心的RA随机对照临床研究病例,随机分为中药组203例和西药组194例,西药治疗方案包括非甾体抗炎药和慢作用药,中药治疗包括基础治疗和辨证用药。按ACR20标准评价治疗3个月和6个月的疗效。观察患者初诊时寒热相关症状和舌象13项,采用因子分析方法将患者分为寒证和热证,分类结果与中医师辨证结果进行对比分析,并比较寒、热证患者的疗效差异。结果:因子分析分类结果与医生辨证的结果一致。西药组3个月疗效中寒证患者有效率51.67%,热证为29.09%;6个月疗效中寒证有效率为88.52%,热证为55.36%,寒证疗效均高于热证,差异有显著性(P<0.05)。结论:依据中医理论对疾病再分类有利于提高治疗方案的针对性。     

来自中医的阴阳与证候

Chinese medicine （CM） basic theory differs substantially from modernmedicine in methodology. CM views the healthy human body as an entity in yin-yang equilibrium. CM practitioners typically diagnose patients with ＂Zheng （CMsyndrome）＂-yin-yang status of specific organs, and the ultimate goal of treatment inCM is to restore the yin-yang balance. This concept might seem strange to Westernperceptions; however, CM philosophy and methodology have been graduallyaccepted and used in the West. There is growing evidence from prestigiousworldwide journals like Nature, Science and Cell indicating that CM theory isbecoming an important component in dealing with health issues in the West.     

Thoughts and Approaches of Integrated Chinese and Western Medicine for the Treatment of Oligo-astheno-teratozoospermia

Oligo-astheno-teratozoospermia (OAT) which perplexes doctors and patients due to its complicated etiology, atypical symptoms and poor clinical efficacy, is a general term for the three pathological states of abnormal semen. OAT is the main factor of male infertility. It is also a hot and difficult point in present studies. Empiric drug is the most popular treatment of this disease in the modern medicine. Chinese medicine (CM) is one of the main methods for the treatment of this disease, and it has certain clinical effect. The author believes that the use of modern medical technology to make the diagnosis as clear as possible is the key to treat OAT. The combination of syndrome and disease differentiation is the main mode in the treatment of OAT. Microscopic syndrome differentiation and macroscopic evidence embodies the basic principle of “Si Wai Chuai Nei” and broadens the perspective of CM syndrome differentiation. Classification and treatment are basic methods for the treatment of OAT. The treatment should not be limited to the Shen (Kidney), instead it should focus on the whole body condition. At different stages, the treatment should also pay attention to strengthening the Pi (Spleen), nourishing the Gan (Liver) and promoting blood circulation. Complementing Chinese and Western medicine, and highlighting the characteristics and advantages of CM treatment, have a great guiding value for the treatment of OAT.     

Chinese Medicine Herbal Treatment Based on Syndrome Differentiation Improves the Overall Survival of Patients with Unresectable Hepatocellular Carcinoma

Objective:To investigate the effects of Chinese medicine(CM) herbal treatment based on syndrome differentiation on patients with unresectable hepatocellular carcinoma(HCC).Methods:A total of 94 patients with unresectable HCC were reviewed between June 2008 and June 2011.Survival analysis was performed between patients who received CM with/without non-curative antitumor treatments of Western medicine(WM)(CM group,30cases) and patients who were not treated with CM but with non-curative antitumor treatments of WM or supportive treatment alone(non-CM group,64 cases).Then,survival analysis was performed between patients treated with CM combined with non-curative antitumor treatments of WM(combination therapy group,25 cases) and patients with non-curative antitumor treatments of WM alone(non-curative antitumor treatments group of WM,52 cases).The survival analysis was performed by Kaplan-Meier method and prognostic factors for overall survival(OS) were assessed by the Cox proportional hazards regression model.Results:The median survival time(MST),1- and 2-year survival rates of the CM group and the non-CM group were 36 months,76.7%,56.1%and 12 months,48.4%,26.6%,respectively.The Log-rank test revealed significant difference between the two groups in OS(P<0.01).Cox proportional multivariate analysis revealed that CM was an independent favorable prognostic factor for OS.The MST,1- and 2-year survival rates of combination therapy group and non-curative antitumor treatments group of WM were 36 months,76.0%,55.5%and 13 months,55.8%,30.8%,respectively.There was significant difference in OS between the two groups(P=0.004).Conclusions:CM herbs based on syndrome differentiation have positive effects on survival of patients with unresectable HCC.Furthermore,combination therapy of CM and WM are recommended in HCC treatment.     

Recent Highlights of Experimental Research for Inhibiting Tumor Growth by Using Chinese Medicine

To give an overview of contemporary experimental research using Chinese medicine (CM) for the treatment of cancer. As an integral part of mainstream medicine in the People''s Republic of China, CM emphasizes improvements in holistic physical condition instead of merely killing tumor cells, which is consistent with the current medical model that advocates patient-oriented treatment. Great progress has been made in experimental research, and the principle aspects include anti-tumor angiogenesis, inducing apoptosis and differentiation, reversing multidrug resistance, and improving immune function. As a current hot topic in cancer research, tumor microenvironment (TME) highlights the mutual and interdependent interaction between tumor cells and their surrounding tissues, and the CM treatment concept bears a striking resemblance to it. To date, primary points of TME include extracellular matrix remodeling, inflammation, hypoxia, and angiogenesis, but trials using CM with a focus on TME are rare. Despite considerable recent development, experimental research on CM for solving cancer issues appears insufficient. Greater efforts in this field are urgently needed.     

中医药与心理疏导对冠心病合并焦虑症和/或抑郁症患者心绞痛疗效的临床研究

目的:观察中医药与心理疏导对冠心病合并焦虑症和/或抑郁症患者心绞痛的疗效.方法:90例患者随机分为A组、B组为治疗组,C组为对照组,予90 d的治疗和14 d随访.治疗前后进行心绞痛症状分级量化表、西雅图心绞痛量表(SAQ)测评,对所得数据进行分析.结果:1、心绞痛症状疗效:治疗前后组内比较,有统计学意义(P<0.05);组间比较,治疗后在主要症状胸痛及总分上A、B两组明显优于C组,有统计学意义(P<0.05).兼次症状改善不显著(P>0.05).2、西雅图心绞痛量表(SAQ)评分疗效:A、B两组五个维度均有明显改善,有统计学意义(P<0.05);在PL、AS两个维度方面,C组改变不大,无统计学意义(P<0.05).组间比较.有统计学意义(P<0.05).结论:中医药与心理疏导疗法可以提高冠心病合并焦虑症和/或抑郁症患者的生存质量,改善心绞痛症状及SAQ评分.     

Policies on Chinese Medicine in China May Have Enlightenments to Complementary and Alternative Medicine in the World

From the event of TU You-you winning the Nobel Prize, this paper briefly reviewed the history of formation and development of policies on Chinese medicine (CM) in China. On the basis of analyzing the causes of policies on CM, it is believed that policies on CM in China may have 4 kinds of enlightenments to the development of complementary and alternative medicine (CAM) in the world. Forming the political advantages of policy-making by main leaders of the country attaching importance to CAM; implementing a diversified health care system policy for the goal of maximizing people’s health interests; ensuring development of CAM by the coerciveness of law and the timeliness of policy adjustment; and promoting the protection and mining, sorting out and improving of CAM based on open and comprehensive policies.