1.Development and validation of a quality appraisal tool for case reports in traditional Chinese medicine using the Delphi method
Duoting TAN ; Hao LIANG ; Yipin YU ; Jin GUO ; Liqin ZHONG ; Zhixi HU
Digital Chinese Medicine 2025;8(2):137-146
Objective:
To develop a quality appraisal tool for case reports in traditional Chinese medicine (TCM) based on their characteristics.
[Methods]:
An extensive literature search was conducted in Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CSTJ), focusing on expert consensus statements and checklists for TCM case reports. Relevant items were extracted, and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale. Items were screened based on measures of central tendency and coordination (including total score, mean score, percentage of items rated as unimportant, and coefficient of variation). The weighted average method was used to determine item weights and construct the appraisal tool. Internal consistency was assessed using Cronbach’s α coefficient. The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports, with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency.
Results:
A total of 9 513 articles were retrieved, and 96 items from 25 articles were extracted. After two rounds of the Delphi method, 27 items across 10 domains were retained. The Cronbach’s α coefficient was 0.72 in the first round (acceptable range), and 0.96 in the second round, indicating strong internal consistency. The tool was piloted by six reviewers, achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845, demonstrating high consistency among reviewers.
Conclusion
The developed TCM case report quality appraisal tool, consisting of 27 items in 10 domains, offers a scientific and reliable means of assessing the quality of TCM case reports. The tool showed high consistency and practical utility, and its application is expected to enhance the standardization, scientific rigor, and evidence quality of TCM case reports, facilitating the integration of traditional medical knowledge with modern evidence-based standards.
2.Visualized Analysis of Advances and Hot Spots of Lianhua Qingwen in Recent 10 Years
Kun LIAN ; Xin LI ; Duoting TAN ; Bo NING ; Zhixi HU ; Lin LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):220-228
ObjectiveTo analyze relevant literature on Lianhua Qingwen preparations and clarify the research advances and hot spots in this field, so as to provide references for clinical rational application and further research. MethodLiterature related to Lianhua Qingwen preparations in the recent 10 years was retrieved from six databases, including China National Knowledge Infrastructure(CNKI), VIP, Wanfang Data, PubMed, and Web of Science, followed by management and analysis by NoteExpress and CiteSpace. ResultFinally, 344 and 76 Chinese and English research articles were included, and the number of publications increased in recent years. The research articles were published in 162 Chinese and 48 English journals. Shijiazhuang Yiling Pharmaceutical Co., Ltd. and Guangzhou Medical University were institutions with the largest number of Chinese and English publications, respectively. LIU Minyan was the author who had published the most articles. Keywords with high frequency included clinical efficacy, Lianhua Qingwen, inflammatory factors, traditional Chinese medicine, and coronavirus disease-2019(COVID-19). Nineteen clusters, including clinical efficacy, Chinese medicine, Lianhua Qingwen, COVID-19, and influenza A virus, and 47 emergent keywords, including herpes zoster, pneumonia, inflammatory factors, influenza, and gut microbiota, were generated. ConclusionCooperation and exchanges in this field are insufficient. Research focuses on the clinical efficacy of Lianhua Qingwen in the treatment of COVID-19 and other diseases, pharmacological action and mechanism of antiviral drugs, and micro-mechanism research focuses on related pathways and target proteins, as well as the combination of Chinese and western medicines.
3.Pathogenesis of Chronic Heart Failure with Anxiety and Depression and Therapeutic Mechanisms of Bupleuri Radix-based Formulas from Theory of Shaoyang Pivot
Duoting TAN ; Kun LIAN ; Hao LIANG ; Lichong MENG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):156-164
Chronic heart failure (CHF), as the terminal stage of various cardiovascular diseases, is characterized by a prolonged clinical course and recurrent exacerbations. The coexistence of CHF with anxiety and depression falls under the category of psycho-cardiological diseases. Studies have demonstrated that anxiety and depression are closely associated with adverse outcomes including elevated risks of cardiovascular events and increased mortality in CHF patients. The complex pathogenesis poses challenges to modern medical treatments, which often face limited efficacy and concurrent side effects. According to the theory of Shaoyang Pivot in traditional Chinese medicine (TCM), this paper elucidates that obstructed Shaoyang Pivot—manifested as Qi transformation disorder, dysregulated fluid metabolism, and abnormal distribution of ministerial fire-serves as a critical pathological basis for CHF with anxiety and depression. Bupleuri Radix-based Formulas, such as Xiao Chaihu Tang, Chaihu Guizhi Tang, and Chaihu Jia Longgu Muli Tang, aim to harmonize lesser Yang to restore the Qi transformation, activate Yang to promote water excretion, and redistribute ministerial fire, thus effectively alleviating pathological states such as Qi stagnation, blood stasis, water retention, and phlegm-fire disturbing the heart in CHF patients with anxiety and depression. Consequently, they mitigate symptoms of this psycho-cardiological disease. Mechanism studies have revealed that Bupleuri Radix-based formulas exhibit multi-target effects, including modulation of neurotransmitters, suppression of inflammatory responses, regulation of lipid metabolism, protection of cardiomyocytes, and improvement of the endothelial function. By interpreting the TCM pathogenesis of CHF with anxiety and depression from the theory of Shaoyang Pivot, this paper delves into the therapeutic principles and mechanisms of Bupleuri Radix-based formulas, providing a theoretical foundation for optimizing TCM diagnosis and treatment strategies for psycho-cardiological diseases.