[Objective]To analyze the current research status and hot topics of traditional Chinese medicine(TCM)in the treatment of multiple sclerosis(MS),and provide references for clinical decision-making,future research and the construction of integrated Chinese and western medicine treatment guidelines.[Methods]Relevant literature published from January 2004 to November 2024 was retrieved from the CNKI,VIP,Wanfang,PubMed and Web of Science(WOS)databases.Using CiteSpace 6.3.R1 software,a visual analysis was performed on publication time,authors,institutions and keywords through co-occurrence,clustering and burst analysis to derive the current research status and hot topics.[Results]A total of 168 articles were included.The number of publications in the field of TCM treatment for MS remained relatively stable in recent years,but the proportion of high-quality clinical studies increased.A stable core group of authors was not yet formed,and research institutions were concentrated in major university-affiliated hospitals and traditional Chinese medicine institutions.High-frequency and high-centrality keywords included syndrome differentiation and treatment,renowned physician experience,integrative Chinese and western medicine,etiology and pathogenesis,and TCM syndromes.[Conclusion]TCM treatment for MS is still in the development stage,with a focus on research related to etiology,pathogenesis and syndrome differentiation.Future efforts should emphasize team and institutional collaborations,development of multi-center networks,improvement of research quality,and exploration of interdisciplinary and multi-modal treatment approaches.High-quality evidence-based research should be promoted to inform clinical decision-making,improve treatment protocols,and contribute to the development of integrated Chinese and western medicine treatment guidelines.

[Objective]To analyze the current research status and hot topics of traditional Chinese medicine(TCM)in the treatment of multiple sclerosis(MS),and provide references for clinical decision-making,future research and the construction of integrated Chinese and western medicine treatment guidelines.[Methods]Relevant literature published from January 2004 to November 2024 was retrieved from the CNKI,VIP,Wanfang,PubMed and Web of Science(WOS)databases.Using CiteSpace 6.3.R1 software,a visual analysis was performed on publication time,authors,institutions and keywords through co-occurrence,clustering and burst analysis to derive the current research status and hot topics.[Results]A total of 168 articles were included.The number of publications in the field of TCM treatment for MS remained relatively stable in recent years,but the proportion of high-quality clinical studies increased.A stable core group of authors was not yet formed,and research institutions were concentrated in major university-affiliated hospitals and traditional Chinese medicine institutions.High-frequency and high-centrality keywords included syndrome differentiation and treatment,renowned physician experience,integrative Chinese and western medicine,etiology and pathogenesis,and TCM syndromes.[Conclusion]TCM treatment for MS is still in the development stage,with a focus on research related to etiology,pathogenesis and syndrome differentiation.Future efforts should emphasize team and institutional collaborations,development of multi-center networks,improvement of research quality,and exploration of interdisciplinary and multi-modal treatment approaches.High-quality evidence-based research should be promoted to inform clinical decision-making,improve treatment protocols,and contribute to the development of integrated Chinese and western medicine treatment guidelines.

Objective We aimed to assess the serum levels of the glycolysis-related protein hypoxia-inducible factor-1α(HIF-1α)and cytokines in patients with relapsing-remitting multiple sclerosis(RRMS)before and after treatment with the traditional Chinese medicine Yishen Daluo Decoction,as well as their correlation with clinical parameters,and explore the immune regulatory mechanism of Yishen Daluo Decoction on multiple sclerosis.Methods Twenty-eight patients with RRMS in remission recruited from May 2018 to January 2022 in the Multiple Sclerosis Clinic at Dongzhimen Hospital,Beijing University of Chinese Medicine were retrospectively included.Comparisons were made with paired samples from 13 of them before and after Yishen Daluo Decoction treatment.A total of 20 gender-and age-matched healthy controls(HCs)were also recruited.Clinical information was collected from all of the subjects,and the neurological impairments of RRMS patients were assessed with the Expanded Disability Status Scale(EDSS)score.ELISA and SP-X multiplex cytokine assays were used to measure the serum levels of HIF-1 α and 10 cytokines(IL-1β,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-22,IFN-γ,and TNF-α),respectively.Spearman's method was used to analyze the correlation between the serum levels of HIF-1α and cytokines,and the correlation between the serum levels of HIF-1α and cytokines and patients'clinical indicators,including disease duration,the number of attacks,and the EDSS score.Results Serum HIF-1α,IL-4,IL-6,IL-8,IL-10,IL-12p70,IFN-γ,and TNF-α levels in the RRMS group were significantly higher than those in the HC group(P＜0.05).Serum levels of HIF-1α,IL-4,IL-6,and IL-12p70 in the Yishen Daluo Decoction-pre group were significantly higher than those in the Yishen Daluo Decoction-post group(P＜0.05).In addition,the serum HIF-1α level was positively correlated with IL-6(r=0.452,P=0.016)and TNF-α(r=0.524,P=0.004)levels in patients with RRMS.The IFN-γ level was negatively correlated with the EDSS score(r=-0.423,P=0.025),the IL-4 level was negatively correlated with disease duration(r=-0.385,P=0.043),and the TNF-α level was positively correlated with disease duration(r=0.397,P=0.037).Conclusion The regulatory mechanism of Yishen Daluo Decoction on immune imbalance in RRMS may be related to its ability to reduce the serum levels of the glycolysis-related protein HIF-1α in RRMS patients.It is also related to the levels of various inflammatory cytokines.