2.Evidence-Based Dampness-Heat ZHENG (Syndrome) in Cancer: Current Progress toward Establishing Relevant Animal Model with Pancreatic Tumor.
Ju-Ying JIAO ; Chien-Shan CHENG ; Zhang-Qi CAO ; Lian-Yu CHEN ; Zhen CHEN
Chinese journal of integrative medicine 2024;30(1):85-95
Cancer is one of the deadliest diseases affecting the health of human beings. With limited therapeutic options available, complementary and alternative medicine has been widely adopted in cancer management and is increasingly becoming accepted by both patients and healthcare workers alike. Chinese medicine characterized by its unique diagnostic and treatment system is the most widely applied complementary and alternative medicine. It emphasizes symptoms and ZHENG (syndrome)-based treatment combined with contemporary disease diagnosis and further stratifies patients into individualized medicine subgroups. As a representative cancer with the highest degree of malignancy, pancreatic cancer is traditionally classified into the "amassment and accumulation". Emerging perspectives define the core pathogenesis of pancreatic cancer as "dampness-heat" and the respective treatment "clearing heat and resolving dampness" has been demonstrated to prolong survival in pancreatic cancer patients, as has been observed in many other cancers. This clinical advantage encourages an exploration of the essence of dampness-heat ZHENG (DHZ) in cancer and investigation into underlying mechanisms of action of herbal formulations against dampness-heat. However, at present, there is a lack of understanding of the molecular characteristics of DHZ in cancer and no standardized and widely accepted animal model to study this core syndrome in vivo. The shortage of animal models limits the ability to uncover the antitumor mechanisms of herbal medicines and to assess the safety profile of the natural products derived from them. This review summarizes the current research on DHZ in cancer in terms of the clinical aspects, molecular landscape, and animal models. This study aims to provide comprehensive insight that can be used for the establishment of a future standardized ZHENG-based cancer animal model.
Animals
;
Humans
;
Medicine, Chinese Traditional
;
Hot Temperature
;
Pancreatic Neoplasms/therapy*
;
Models, Animal
;
Syndrome
3.Effectiveness of Acupoint Application in Patients with Pharyngeal Pain: Evidence from CHUNBO, A Prospective Real-World Study.
Hang-Kun MA ; Yi-Ming WANG ; Man-Ping GUO ; Chen-Fei LI ; Rui LI ; Rui GAO
Chinese journal of integrative medicine 2024;30(1):18-24
OBJECTIVE:
To assess the outcomes after acupoint application in patients with pharyngeal pain in a real-world settings, and analyze the characteristics of effective population and prescription characteristics of acupoint application.
METHODS:
Based on CHUNBO platform, patients with pharyngeal pain who were candidates for acupoint application on the basis of physician-evaluation, were enrolled in a nationwide, prospective, 69-week multicenter observational study from August 2020 to February 2022. Propensity score matching (PSM) was used to match the confounding factors and the association rules were used to analyze the characteristics of effective population and prescription characteristics of acupoint application. Outcome assessments included the disappearance rate of pharyngeal pain (within 3, 7, and 14 days), disappearance time of pharyngeal pain, as well as adverse events.
RESULTS:
Of 7,699 enrolled participants, 6,693 (86.9%) received acupoint application and 1,450 (21.7%) with non-acupoint application. After PSM, there were 1,004 patients each in the application group (AG) and non-application group (NAG). The disappearance rate of pharyngeal pain in the AG at 3, 7, and 14 days were all higher than those in the NAG (P<0.05). The disappearance time of pharyngeal pain in the AG were shorter than that in the NAG (logrank P<0.001, hazard ratio=1.51, 95% confidence interval: 1.41-1.63). The median age of effective cases was 4 years, mainly 3-6 years old (40.21%). The disappearance rate of pharyngeal pain in the application group with tonsil diseases was 2.19 times higher than that in the NAG (P<0.05). The commonly used acupoints for the effective cases were Tiantu (RN 22), Shenque (RN 8) and Dazhui (DU 14). The commonly used herbs for the effective cases were Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae. Among them, Natrii sulfas was applied to RN 8 most frequently (support 84.39%). A total of 1,324 (17.2%) patients experienced AEs, and mainly occurred in the AG, with significant difference in the incidence of AEs between goups (P<0.05). All AEs reported were the first grade, and the average regression days of AEs was 2.8 days.
CONCLUSIONS
Acupoint application in patients with pharyngeal pain resulted in improved effective rate and shortened duration, especially children aged 3-6 years old, and those with tonsil diseases. Acupoint of RN 22, RN 8 and DU 14, Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae were the most commonly used herbs in the treatment of pharyngeal pain.
Child
;
Humans
;
Child, Preschool
;
Acupuncture Points
;
Medicine, Chinese Traditional/methods*
;
Prospective Studies
;
Pain
4.Research Advance of Chinese Medicine in Treating Atherosclerosis: Focus on Lipoprotein-Associated Phospholipase A2.
Lu-Ming WANG ; Wen-Lan ZHANG ; Nuan LYU ; Yan-Rong SUO ; Lin YANG ; Bin YU ; Xi-Juan JIANG
Chinese journal of integrative medicine 2024;30(3):277-288
As a serious cardiovascular disease, atherosclerosis (AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 (PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatidylcholine (oxPC) to produce lysophosphatidylcholine (lysoPC). Moreover, macrophage apoptosis within plaque is promoted by localized Lp-PLA2 which also promotes plaque instability. This paper reviews those researches of Chinese medicine in treating AS via reducing Lp-PLA2 levels to guide future experimental studies and clinical applications related to AS.
Humans
;
1-Alkyl-2-acetylglycerophosphocholine Esterase
;
Medicine, Chinese Traditional
;
Atherosclerosis/drug therapy*
;
Lipoproteins
;
Plaque, Atherosclerotic
;
Biomarkers
5.Knowledge Graph Enhanced Transformers for Diagnosis Generation of Chinese Medicine.
Xin-Yu WANG ; Tao YANG ; Xiao-Yuan GAO ; Kong-Fa HU
Chinese journal of integrative medicine 2024;30(3):267-276
Chinese medicine (CM) diagnosis intellectualization is one of the hotspots in the research of CM modernization. The traditional CM intelligent diagnosis models transform the CM diagnosis issues into classification issues, however, it is difficult to solve the problems such as excessive or similar categories. With the development of natural language processing techniques, text generation technique has become increasingly mature. In this study, we aimed to establish the CM diagnosis generation model by transforming the CM diagnosis issues into text generation issues. The semantic context characteristic learning capacity was enhanced referring to Bidirectional Long Short-Term Memory (BILSTM) with Transformer as the backbone network. Meanwhile, the CM diagnosis generation model Knowledge Graph Enhanced Transformer (KGET) was established by introducing the knowledge in medical field to enhance the inferential capability. The KGET model was established based on 566 CM case texts, and was compared with the classic text generation models including Long Short-Term Memory sequence-to-sequence (LSTM-seq2seq), Bidirectional and Auto-Regression Transformer (BART), and Chinese Pre-trained Unbalanced Transformer (CPT), so as to analyze the model manifestations. Finally, the ablation experiments were performed to explore the influence of the optimized part on the KGET model. The results of Bilingual Evaluation Understudy (BLEU), Recall-Oriented Understudy for Gisting Evaluation 1 (ROUGE1), ROUGE2 and Edit distance of KGET model were 45.85, 73.93, 54.59 and 7.12, respectively in this study. Compared with LSTM-seq2seq, BART and CPT models, the KGET model was higher in BLEU, ROUGE1 and ROUGE2 by 6.00-17.09, 1.65-9.39 and 0.51-17.62, respectively, and lower in Edit distance by 0.47-3.21. The ablation experiment results revealed that introduction of BILSTM model and prior knowledge could significantly increase the model performance. Additionally, the manual assessment indicated that the CM diagnosis results of the KGET model used in this study were highly consistent with the practical diagnosis results. In conclusion, text generation technology can be effectively applied to CM diagnostic modeling. It can effectively avoid the problem of poor diagnostic performance caused by excessive and similar categories in traditional CM diagnostic classification models. CM diagnostic text generation technology has broad application prospects in the future.
Humans
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Medicine, Chinese Traditional
;
Pattern Recognition, Automated
;
Asian People
;
Language
;
Learning
6.Polysaccharides from Chinese herbal medicine: a review on the hepatoprotective and molecular mechanism.
Jifeng LI ; Haolin GUO ; Ying DONG ; Shuo YUAN ; Xiaotong WEI ; Yuxin ZHANG ; Lu DONG ; Fei WANG ; Ting BAI ; Yong YANG
Chinese Journal of Natural Medicines (English Ed.) 2024;22(1):4-14
Polysaccharides, predominantly extracted from traditional Chinese medicinal herbs such as Lycium barbarum, Angelica sinensis, Astragalus membranaceus, Dendrobium officinale, Ganoderma lucidum, and Poria cocos, represent principal bioactive constituents extensively utilized in Chinese medicine. These compounds have demonstrated significant anti-inflammatory capabilities, especially anti-liver injury activities, while exhibiting minimal adverse effects. This review summarized recent studies to elucidate the hepatoprotective efficacy and underlying molecular mechanisms of these herbal polysaccharides. It underscored the role of these polysaccharides in regulating hepatic function, enhancing immunological responses, and improving antioxidant capacities, thus contributing to the attenuation of hepatocyte apoptosis and liver protection. Analyses of molecular pathways in these studies revealed the intricate and indispensable functions of traditional Chinese herbal polysaccharides in liver injury management. Therefore, this review provides a thorough examination of the hepatoprotective attributes and molecular mechanisms of these medicinal polysaccharides, thereby offering valuable insights for the advancement of polysaccharide-based therapeutic research and their potential clinical applications in liver disease treatment.
Humans
;
Drugs, Chinese Herbal/pharmacology*
;
Liver Diseases/drug therapy*
;
Antioxidants
;
Polysaccharides/therapeutic use*
;
Medicine, Chinese Traditional
7.Effects of traditional Chinese medicine on treatment outcomes in severe COVID-19 patients: a single-centre study.
Yongjiu XIAO ; Binbin LI ; Chang LIU ; Xiuyu HUANG ; Ling MA ; Zhirong QIAN ; Xiaopeng ZHANG ; Qian ZHANG ; Dunqing LI ; Xiaoqing CAI ; Xiangyong YAN ; Shuping LUO ; Dawei XIANG ; Kun XIAO
Chinese Journal of Natural Medicines (English Ed.) 2024;22(1):89-96
As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.
Humans
;
COVID-19
;
Medicine, Chinese Traditional
;
SARS-CoV-2
;
Critical Illness
;
Treatment Outcome
8.Chinese Medicine External Therapy Combined with Conventional Drug Treatment for Rheumatoid Arthritis: A Systematic Review and Meta-analysis
Sin Wei Tang ; Zhi Hang Wong ; Ket Li Ho ; Dahlya Qasryna Binti Zulkifli ; Jia Wen Koo ; Yung Chein Yong
International e-Journal of Science, Medicine and Education 2024;18(1):40-65
Introduction:
Chinese medicine (CM) external therapy is commonly used to treat rheumatoid arthritis (RA) in combination with conventional drug. This study aims to provide a comprehensive synthesis on the efficacy of CM external therapy combined with conventional drug treatment in RA.
Methods:
Randomised controlled trials (RCTs) experimenting the efficacy of CM external therapy (acupuncture, moxibustion and CM fumigation) combined with conventional drug in comparison with conventional drug only in RA patients were collected from PubMed, Medline, Cochrane Central of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), and Wanfang databases. Quality was assessed using the Cochrane Risk of Bias Tool. The outcome measures which include Disease Activity Score-28 (DAS28), Visual Analogue Scale (VAS), Swollen Joint Count (SJC), Tumour Necrosis Factor (TNF-α), serum levels of C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) were analysed using Review Manager 5.4.1 and GRADEpro GDT online software.
Results:
Fifty RCTs fulfilling the criteria were included. Although some level of efficacy was statistically noted on the use of CM external therapies, their certainty levels are mixed, ranging only in between moderate and low.
Conclusions
Mixed levels of certainty has hindered the drawing of conclusion. The addition of CM external therapies to conventional drug treatment may provide some benefits in RA. Further clinical trials with considerations in minimising the risk of bias are recommended to provide more high-quality evidence in the effect of CM external therapies as a complementary treatment in RA.
Medicine, Chinese Traditional
;
Fumigation
;
Meta-Analysis [Publication Type]
;
Moxibustion
;
Arthritis, Rheumatoid
;
Systematic Review [Publication Type]
9.Evolution of acupuncture techniques for jin diseases and the rise and fall of jingjin doctrine.
Chinese Acupuncture & Moxibustion 2023;43(8):855-867
It has the important enlightenment and reference significance for the inheritance and innovation of jin (sinew/fascia) diseases and its theoretic basis, jingjin (muscle region of meridian) doctrine by sorting out the origin of the acupuncture techniques for jin diseases and exploring the root of its rise and fall. Using context analysis, overall investigation and practice test, the paper elaborates the basic concepts, e.g. needling techniques for jin, jingjin, jinji (muscular contracture) and jiejin (knotted tendon), and jingjin doctrine. In particular, the three key concepts, i.e. fanzhen jieci (heating after needling), yizhi weishu (feelings from patients and acupuncture operators) and yitong weishu (the worst painful sites of muscle spasm) are deeply investigated. These three concepts, involved in the treatment of jingjin disorders, treatment principles and methods, are of a great controversy in the current academic circle. The author clarified the category of needling for jin disease and main needling techniques, investigated specially the origin of fanzhen jieci and guancifa (repeated needling directly on the foci), and explored the evolution of the needling methods that had been controversial or neglected for a long time, i.e. neire cifa (technique for inducing heat inside for cold obstruction), guancifa, tiaocifa (inserting the needles around the foci), fencifa (intramuscular needling) and mucifa (deep puncturing to the peritoneum or on front-mu points). Finally, from the relationship between jin and mai (meridian), and the differences between dry needling and acupuncture technique for jin diseases, the author explored the crucial problems and countermeasures urgently required in the future development of jingjin doctrine so as to provide the references for the theoretical innovation of acupuncture- moxibustion science.
Humans
;
Acupuncture Points
;
Acupuncture Therapy/methods*
;
Meridians
;
Moxibustion
;
Medicine, Chinese Traditional
10.Fascia and defensive qi: construction of body view in classical acupuncture theory.
Chinese Acupuncture & Moxibustion 2023;43(8):871-875
Influenced by the concept of "qi-void" in Taoist philosophy during the Qin and Han dynasties, the early acupuncture theory attaches the importance to the "fascial (muscular) interstices" distributed widely in the human body. The defensive qi runs through everywhere in these interstices that is easily invaded by the pathogenic wind and cold, and bi syndrome of jingjin (muscle region of meridian) is involved. Besides, fascial (muscular) interstices are the places for the delivery of relaxing needling and joint needling. Fascial tissue is a crucial structure to produce deqi, while, the function of defensive qi is tightly connected to the autonomic nerve in modern medicine, both of which actually belong to the different expressions of patients' body feeling. Medical scholars at early era, in reference with "fascia" and "defensive qi ", has summarized and refined their clinical practice experience. Thereby, the concepts of "arrival of qi " and "fascial (muscular) interstices" are extended, which constructs the peripheral framework of core concepts in acupuncture theoretic system, e.g. meridians and acupoints, and becomes an important component of the body view in classic acupuncture theory.
Humans
;
Qi
;
Acupuncture Therapy
;
Meridians
;
Acupuncture
;
Acupuncture Points


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