Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

ObjectiveTo investigate the therapeutic effect of sequential administration of Dihuang Baoyuan granules （DHBY， the prescription for consolidating body resistance） and Fuling Yunhua granules （FLYH， the prescription for treating symptoms） on spontaneous type 2 diabetes mellitus （T2DM） in mice. MethodsAccording to the fasting blood glucose （FBG） level， 12-week-old db/db mice were randomized into six groups： model， DHBY （18.02 g·kg^-1）， FLYH （14.80 g·kg^-1）， sequential administration 1 （SEQ-1， DHBY 18.02 g·kg^-1+FLYH 14.80 g·kg^-1）， sequential administration 2 （SEQ-2， FLYH 14.80 g·kg^-1+DHBY 18.02 g·kg^-1）， and dapagliflozin （Dapa， 1.3 mg·kg^-1）. The m/m mice in the same litter were selected as the normal group. The mice were administrated with corresponding drugs by gavage for 8 consecutive weeks. During the 8 weeks of drug administration and 2 weeks after withdrawal， the retinal thickness， FBG， hemoglobin A1c （HbA1c）， and insulin were determined， and histopathological changes of the pancreas， liver， kidney， and retina were observed by hematoxylin-eosin （HE） staining. ResultsCompared with the model group， SEQ-1 for 4 weeks lowered the FBG level （P<0.05）， raised the insulin level， decreased the triglyceride （TG） level （P<0.05）， increased the number of optic ganglion cells and diminished vacuolar degeneration of pancreatic islet and liver. SEQ-2 lowered FBG and HbA1c levels （P<0.05）， rose the insulin level， increased the retinal thickness and the number of optic ganglion cells （P<0.05）， and alleviated vacuolar degeneration of pancreatic islet and liver. Two weeks after drug withdrawal， Dapa tended to increase FBG and HbA1c compared with those at the time of drug withdrawal. However， the levels of FBG and HbA1c in the SEQ-2 group remained decreasing （P<0.05）. ConclusionSEQ-1 and SEQ-2 can lower the blood glucose level and ameliorate diabetic retinopathy， and SEQ-2 outperformed DHBY and FLYH in lowering the blood glucose level. Moreover， SEQ-2 can maintain the blood glucose-lowering effect after drug withdrawal.

ObjectiveTo investigate the therapeutic effect of sequential administration of Dihuang Baoyuan granules （DHBY， the prescription for consolidating body resistance） and Fuling Yunhua granules （FLYH， the prescription for treating symptoms） on spontaneous type 2 diabetes mellitus （T2DM） in mice. MethodsAccording to the fasting blood glucose （FBG） level， 12-week-old db/db mice were randomized into six groups： model， DHBY （18.02 g·kg^-1）， FLYH （14.80 g·kg^-1）， sequential administration 1 （SEQ-1， DHBY 18.02 g·kg^-1+FLYH 14.80 g·kg^-1）， sequential administration 2 （SEQ-2， FLYH 14.80 g·kg^-1+DHBY 18.02 g·kg^-1）， and dapagliflozin （Dapa， 1.3 mg·kg^-1）. The m/m mice in the same litter were selected as the normal group. The mice were administrated with corresponding drugs by gavage for 8 consecutive weeks. During the 8 weeks of drug administration and 2 weeks after withdrawal， the retinal thickness， FBG， hemoglobin A1c （HbA1c）， and insulin were determined， and histopathological changes of the pancreas， liver， kidney， and retina were observed by hematoxylin-eosin （HE） staining. ResultsCompared with the model group， SEQ-1 for 4 weeks lowered the FBG level （P<0.05）， raised the insulin level， decreased the triglyceride （TG） level （P<0.05）， increased the number of optic ganglion cells and diminished vacuolar degeneration of pancreatic islet and liver. SEQ-2 lowered FBG and HbA1c levels （P<0.05）， rose the insulin level， increased the retinal thickness and the number of optic ganglion cells （P<0.05）， and alleviated vacuolar degeneration of pancreatic islet and liver. Two weeks after drug withdrawal， Dapa tended to increase FBG and HbA1c compared with those at the time of drug withdrawal. However， the levels of FBG and HbA1c in the SEQ-2 group remained decreasing （P<0.05）. ConclusionSEQ-1 and SEQ-2 can lower the blood glucose level and ameliorate diabetic retinopathy， and SEQ-2 outperformed DHBY and FLYH in lowering the blood glucose level. Moreover， SEQ-2 can maintain the blood glucose-lowering effect after drug withdrawal.

To summarize rescuing and nursing experience of 3 ectopic pregnancy patients,suffering from severe toxicity caused by low-dose methotrexate(MTX)treatment.The key points include:constantly monitoring of patients for at least a week after MTX administration,and identifying MTX toxicity related symptoms as soon as possible;promptly establishing a multidisciplinary medical team to establish individualized rescue plans;quickly initiating the rescue therapy and implementing targeted fluid management to accelerate MTX excretion;intensifying protective isolation caring to prevent and control infection;applying refined safety management to prevent spontaneous bleeding;providing intensive caring of skin and mucosal toxicity symptoms to promote healing process;supplying individualized psychological counseling and support in time;strengthening the protection of the damaged organ.After emergent rescuing and intensive nursing,all 3 patients successfully recovered and were discharged from the hospital.

Aplastic anemia is a rare and life-threatening bone marrow failure that is becoming more common and tends to affect younger individuals.Traditional Chinese medicine has a long history of preventing and treating asthenia and blood syndrome.Its treatment of aplastic anemia involves coordinated regulation through multiple components,targets,and channels.The article classifies and elaborates on the therapeutic effects of traditional Chinese medicine compounds and their components on aplastic anemia.As well as the expression of related factors from three aspects:hematopoietic stem/progenitor cells,the immune system,and bone marrow microenvironmental abnormalities.It also analyzes the frequency and meridian of commonly used drugs in traditional Chinese medicine compounds.Deficiency tonifying drugs were found to be the most frequently used treatment for aplastic anemia,which is consistent with the deficiency-based nature of the disease.The related organs affected are the liver,spleen,and kidney.This paper reviews the mechanism of aplastic anemia and the preventive and therapeutic effects of traditional Chinese medicine.The study is of great significance for the follow-up research on traditional Chinese medicine in improving aplastic anemia.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective To investigate the correlation between brain iron content and cognitive function in patients with Alzheimer's disease(AD),and to assess the diagnostic value of iron deposition in AD using quantitative susceptibility mapping(QSM)technology.Methods Forty-three patients with AD who visited the Second Affiliated Hospital of Xinjiang Medical University between January 2024 and December 2024,and 42 healthy controls matched for gender and age were enrolled in the study.Comprehensive clinical data were collected from all participants.All subjects underwent brain MRI scans using a Philips Ingenia CX 3.0T magnetic resonance imaging system,including both QSM and conventional cranial MRI sequences.The acquired QSM images were post-processed and normalized using the STISuite software package,and the iron content in predefined regions of interest was quantified using ITK-SNAP.All participants also underwent neuropsychological assessments.Differences in regional brain iron content between AD patients and healthy controls were analyzed and compared.Spearman's correlation coefficient was calculated to evaluate the relationship between iron levels in the frontal cortex,basal ganglia,and hippocampus and cognitive performance.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic accuracy of iron deposition in differentiating AD patients from healthy controls.Results(1)Compared with the control group,the magnetic susceptibility values in the basal ganglia and hippocampus of the AD group showed statistically significant differences(P<0.01),with higher values observed in the AD group.No statistically significant difference was found in the susceptibility values of the frontal cortex between the AD group and the control group(P>0.05).(2)In the AD group,the susceptibility values of the left caudate nucleus and left hippocampus tail were negatively correlated with the MMSE scores(P<0.05).Additionally,the susceptibility values of the left caudate nucleus,left putamen,left hippocampus,and left hippocampus tail were negatively correlated with the MOCA scores(P<0.05).(3)The area under the curve(AUC)for diagnosing AD based on the left caudate nucleus was 0.758(95%CI:0.649-0.867),for the left putamen it was 0.719(95%CI:0.606-0.831),and for the left hippocampus tail it was 0.640(95%CI:0.518-0.763).Conclusions(1)The iron content in certain brain regions of AD patients is elevated compared to that in healthy controls,particularly in the basal ganglia and hippocampus.(2)The iron concentration in the brains of AD patients,especially in the left caudate nucleus,left putamen,left hippocampus,and hippocampal tail,is negatively correlated with cognitive function.Higher iron levels are associated with more severe cognitive impairment,suggesting that iron accumulation may serve as a potential biomarker for assessing disease severity.(3)Iron deposition in the left caudate nucleus and left putamen demonstrates certain diagnostic value for AD and holds promise as an imaging marker for the auxiliary diagnosis of the disease.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective To investigate the correlation between brain iron content and cognitive function in patients with Alzheimer's disease(AD),and to assess the diagnostic value of iron deposition in AD using quantitative susceptibility mapping(QSM)technology.Methods Forty-three patients with AD who visited the Second Affiliated Hospital of Xinjiang Medical University between January 2024 and December 2024,and 42 healthy controls matched for gender and age were enrolled in the study.Comprehensive clinical data were collected from all participants.All subjects underwent brain MRI scans using a Philips Ingenia CX 3.0T magnetic resonance imaging system,including both QSM and conventional cranial MRI sequences.The acquired QSM images were post-processed and normalized using the STISuite software package,and the iron content in predefined regions of interest was quantified using ITK-SNAP.All participants also underwent neuropsychological assessments.Differences in regional brain iron content between AD patients and healthy controls were analyzed and compared.Spearman's correlation coefficient was calculated to evaluate the relationship between iron levels in the frontal cortex,basal ganglia,and hippocampus and cognitive performance.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic accuracy of iron deposition in differentiating AD patients from healthy controls.Results(1)Compared with the control group,the magnetic susceptibility values in the basal ganglia and hippocampus of the AD group showed statistically significant differences(P<0.01),with higher values observed in the AD group.No statistically significant difference was found in the susceptibility values of the frontal cortex between the AD group and the control group(P>0.05).(2)In the AD group,the susceptibility values of the left caudate nucleus and left hippocampus tail were negatively correlated with the MMSE scores(P<0.05).Additionally,the susceptibility values of the left caudate nucleus,left putamen,left hippocampus,and left hippocampus tail were negatively correlated with the MOCA scores(P<0.05).(3)The area under the curve(AUC)for diagnosing AD based on the left caudate nucleus was 0.758(95%CI:0.649-0.867),for the left putamen it was 0.719(95%CI:0.606-0.831),and for the left hippocampus tail it was 0.640(95%CI:0.518-0.763).Conclusions(1)The iron content in certain brain regions of AD patients is elevated compared to that in healthy controls,particularly in the basal ganglia and hippocampus.(2)The iron concentration in the brains of AD patients,especially in the left caudate nucleus,left putamen,left hippocampus,and hippocampal tail,is negatively correlated with cognitive function.Higher iron levels are associated with more severe cognitive impairment,suggesting that iron accumulation may serve as a potential biomarker for assessing disease severity.(3)Iron deposition in the left caudate nucleus and left putamen demonstrates certain diagnostic value for AD and holds promise as an imaging marker for the auxiliary diagnosis of the disease.

To summarize rescuing and nursing experience of 3 ectopic pregnancy patients,suffering from severe toxicity caused by low-dose methotrexate(MTX)treatment.The key points include:constantly monitoring of patients for at least a week after MTX administration,and identifying MTX toxicity related symptoms as soon as possible;promptly establishing a multidisciplinary medical team to establish individualized rescue plans;quickly initiating the rescue therapy and implementing targeted fluid management to accelerate MTX excretion;intensifying protective isolation caring to prevent and control infection;applying refined safety management to prevent spontaneous bleeding;providing intensive caring of skin and mucosal toxicity symptoms to promote healing process;supplying individualized psychological counseling and support in time;strengthening the protection of the damaged organ.After emergent rescuing and intensive nursing,all 3 patients successfully recovered and were discharged from the hospital.