Administration Of Traditional Chinese Medicine Research Articles

Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis : A Randomized Clinical Trial.

Acupuncture may improve degenerative lumbar spinal stenosis (DLSS), but evidence is insufficient. To investigate the effect of acupuncture for DLSS. Multicenter randomized clinical trial. (ClinicalTrials.gov: NCT03784729). 5 hospitals in China. Patients with DLSS and predominantly neurogenic claudication pain symptoms. 18 sessions of acupuncture or sham acupuncture (SA) over 6 weeks, with 24-week follow-up after treatment. The primary outcome was change from baseline in the modified Roland-Morris Disability Questionnaire ([RMDQ] score range, 0 to 24; minimal clinically important difference [MCID], 2 to 3). Secondary outcomes were the proportion of participants achieving minimal (30% reduction from baseline) and substantial (50% reduction from baseline) clinically meaningful improvement per the modified RMDQ. A total of 196 participants (98 in each group) were enrolled. The mean modified RMDQ score was 12.6 (95% CI, 11.8 to 13.4) in the acupuncture group and 12.7 (CI, 12.0 to 13.3) in the SA group at baseline, and decreased to 8.1 (CI, 7.1 to 9.1) and 9.5 (CI, 8.6 to 10.4) at 6 weeks, with an adjusted difference in mean change of -1.3 (CI, -2.6 to -0.03; P = 0.044), indicating a 43.3% greater improvement compared with SA. The between-group difference in the proportion of participants achieving minimal and substantial clinically meaningful improvement was 16.0% (CI, 1.6% to 30.4%) and 12.6% (CI, -1.0% to 26.2%) at 6 weeks. Three cases of treatment-related adverse events were reported in the acupuncture group, and 3 were reported in the SA group. All events were mild and transient. The SA could produce physiologic effects. Acupuncture may relieve pain-specific disability among patients with DLSS and predominantly neurogenic claudication pain symptoms, although the difference with SA did not reach MCID. The effects may last 24 weeks after 6-week treatment. 2019 National Administration of Traditional Chinese Medicine "Project of building evidence-based practice capacity for TCM-Project BEBPC-TCM" (NO. 2019XZZX-ZJ).

Research Progress in Traditional Chinese Medicine Treatment of Knee Osteoarthritis

Knee osteoarthritis (KOA) is a degenerative disease characterized by pathological changes in the cartilage and subchondral bone of the knee joint. Initially, knee joint pain is the main symptom, and in the later stages, deformities and mobility disorders may occur. Modern medicine lacks effective treatment methods for early and mid stage KOA, and has drawbacks such as significant side effects and high costs. A large number of studies have confirmed that traditional Chinese medicine has unique advantages in treating KOA, and has obvious advantages such as small trauma, low cost, and definite therapeutic effect, which are gradually being accepted by a large number of KOA patients. The commonly used methods for preventing and treating KOA with traditional Chinese medicine in clinical practice include: oral administration of traditional Chinese medicine, external application of traditional Chinese medicine, fumigation, acupuncture therapy, massage therapy for regulating tendons, and targeted penetration therapy of traditional Chinese medicine. According to relevant literature, traditional Chinese medicine can significantly alleviate knee joint symptoms and improve knee joint function in patients with knee osteoarthritis, which is of great significance for the prevention and treatment of knee osteoarthritis. This article provides a review of the research progress in the prevention and treatment of KOA using traditional Chinese medicine in recent years.

Regulatory Frameworks for Integrated Medicine Management in USA, Europe, Japan, and China

Integrated Medicine Management (IMM) is an all-encompassing healthcare approach that merges conventional Western medicine with complementary and alternative therapies. The primary objective of IMM is to address the underlying causes of illnesses and promote overall health and wellness of patients. As the utilization of complementary and alternative therapies becomes increasingly prevalent, the need for regulatory frameworks to ensure the safe and effective integration of these therapies into conventional healthcare systems is growing rapidly. Regulatory framework of IMM varies between countries, considering the facts that each country has its own unique approach to manage the integration of complementary and alternative therapies. In this article, we aim to explore the regulatory frameworks for IMM in four major markets, i.e. the United States (US), European Union (EU), Japan, and China. In the US, IMM regulation is centralized among different Federal agencies, however states have varying degrees of oversight. The US Food and Drug Administration (FDA) is responsible for regulating dietary supplements and herbal products, while state medical boards oversee the practice of alternative medicine. Additionally, the National Center for Complementary and Integrative Health (NCCIH) provides research and education on complementary and alternative therapies. Conversely, the regulation of IMM is more centralized in EU, where the European Medicines Agency (EMA) oversees the approval of herbal and homeopathic medicines, and the European Commission provides guidelines for the use of complementary and alternative therapies in healthcare. In Japan, the regulation of IMM is tightly controlled by the Ministry of Health, Labour and Welfare (MHLW), which approves traditional herbal medicines and acupuncture needles, and mandates practitioners to be licensed. China recognizes traditional medicine alongside with Western medicine. The State Administration of Traditional Chinese Medicine (SATCM) oversees the regulation of traditional medicine and promotes its integration with Western medicine.

Traditional Chinese Medicine as the Preventive and Therapeutic Remedy for COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic still has tremendous impacts on the global socio-economy and quality of living. The traditional Chinese Medicines (TCM) approach showed encouraging results during previous outbreaks of Severe Acute Respiratory Syndrome-related Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). With limited treatment availability, TCM herbs and formulations could be useful to reduce COVID-19 symptoms and potential sources for discovering novel therapeutic targets. We reviewed 12 TCM herbs and formulations recommended for COVID-19 management by the National Health Commission and as National Administration of Traditional Chinese Medicine of the People's Republic of China. This article explored the Chinese national authorities' guidelines from 2003 to 2020, the scientific data in public databases for the recommended TCM remedies, and their potential mechanistic actions in COVID-19 management. Several TCM herbs and formulations could potentially benefit COVID-19 management. The recommended TCM oral preparations list includes Huoxiang zhengqi, Jinhua Qinggan, Lianhua Qingwen, and Shufeng jiedu; the recommended injection preparations comprise Xiyanping Xuebijing, Re-Du-Ning, Tanreqing, Xingnaojing, Shenfu, Shengmai, and Shenmai. TCM remedies are viable options for symptom alleviation and management of COVID-19. The current SARS-CoV-2 pandemic presents an opportunity to find novel therapeutic targets from TCM-active ingredients. Despite the recommendations in Chinese National guidelines, these remedies warrant further assessments in well-designed clinical trials to ascertain their efficacy in the treatment of COVID-19.

Expert consensus on core indicators for lifecycle value assessment of Chinese patent medicine

The establishment of core indicators for assessment plays an important role in carrying out the lifecycle value assessment of Chinese patent medicine, which are developed based on the concepts such as clinical value oriented, paying attention to the human use experience, and whole process quality control. To this end, the Specialty Committee of Data Monitoring and Decision Making of the World Federation of Chinese Medicine Societies organized experts to draft the Expert Consensus on Core Indicators for Lifecycle Value Assessment of Chinese Patent Medicine based on the research including Chinese Medicine Registration Review Evidence System in Combination of Traditional Chinese Medicine Theory, Human Use Experience, and Clinical Trials(GZY-FJS-2022-206) by National Administration of Traditional Chinese Medicine. This consensus proposed 92 core indicators from four stages, including new drug R&D project approval, pre-clinical research, new drug marketing authorization, and post-marketing, combining the assessment purposes and needs of different stakeholders from different dimensions such as clinical needs, clinical positioning, human use experience, effectiveness, safety, quality control, innovation, accessibility, and suitability. This consensus also interpreted the indicators to clearly elucidate the core elements of the value assessment of Chinese patent medicine in different R&D stages and guided the stakeholders to identify, analyze, and assess the value of Chinese patent medicine in the R&D and use process based on the core indicators in a scientific, objective, and standardized approach. This consensus is expected to play an important role in the high-quality new drug development, drug pricing and compensation of Chinese patent medicine, the development of clinical pathways, and rational clinical application.

Clinical Efficacy of Traditional Chinese Medicine Orthopedic in the Treatment of Senile Osteoarthritis

Objective: This paper aims to explore and analyze the clinical effect of traditional Chinese medicine (TCM) orthopedic treatment on elderly patients with osteoarthritis. Methods: The study period is from January 2021 to June 2023. 62 elderly patients with osteoarthritis admitted to our hospital were selected and divided into the study group (n = 31) and the control group (n = 31) using the random number table scheme. The patients in the control group were treated with conventional Western medicine acemetacin, and the patients in the study group were treated with traditional Chinese medicine orthopedic. The treatment options included manual massage, traditional Chinese medicine fumigation, and oral administration of traditional Chinese medicine. The clinical effective rate, osteoarthritis function Japanese Orthopedic Association score (JOA), visual analogue pain score (VAS), and incidence of adverse reactions were compared between the two groups. Results: The clinical effective rate of patients in the study group was higher than that of the control group (P < 0.05), the JOA score of the patients in the study group was higher than that of the control group after treatment (P < 0.05), while the VAS score of the patients in the study group was lower than that of the control group after treatment (P < 0.05). Plus, the incidence of adverse reactions in the study group was lower than that in the control group (P < 0.05). Conclusions: TCM orthopedic treatment for elderly patients with osteoarthritis has a significant effect, it can improve joint function, relieve pain, with a low incidence of adverse reactions, which can be widely applied in clinical practice.

A Nearly 20‐Year Journey to Success of Azvudine for Antiviral Therapy

Comprehensive SummaryModified nucleosides, particularly those with 4'‐modifications, are significant nucleosides used in antiviral treatments. The drug discovery campaign of Azvudine starts from 2′‐deoxynucleoside, followed by extensive modifications, such as introducing the 4’‐position substitutions, a 2’‐β‐fluoro atom, and changing the nucleobases. Azvudine acts potently toward various HIV‐1 strains by inhibiting HIV‐1 reverse transcription and preventing Vif‐induced A3G degradation, representing the first‐in‐class dual‐acting antiviral agent. In July 2021, the NMPA conditionally approved Azvudine as an adjunct therapy for adult patients with high levels of HIV‐1 virus load when combined with NRTIs or NNRTIs. Azvudine is capable of inhibiting SARS‐CoV‐2, as well as its variants, including Alpha, Beta, Delta, and Omicron. Clinical trials have revealed its real‐world effectiveness among hospitalized severely or critically ill COVID‐19 patients or those with pre‐existing conditions. On July 25th, 2022, the NMPA granted conditional authorization approving Azvudine as China's first domestic oral anti‐COVID‐19 agent. Generally, Azvudine at therapeutic doses is safe and well‐tolerated in clinical settings. Azvudine got approval from the National Health Commission and National Administration of Traditional Chinese Medicine on August 9th to be used in the "Diagnosis and Treatment Program for Novel Coronavirus Pneumonia (Ninth Edition)" for treating common COVID‐19 adult patients. On August 12th, 2022, it was also approved by the National Healthcare Security Administration to be added to the list of medical reimbursements. Of note, the achievements related to Azvudine were indexed in the China Basic Research Development Report in Thirty‐Five of 2022. Azvudine was also approved on January 5th, 2023, to be used in the "Diagnosis and Treatment Program for Novel Coronavirus Pneumonia (Tenth Edition)" for treating COVID‐19 patients. In February 2023, the Ministry of Health of the Russian Federation approved the usage of Azvudine among individuals infected with SARS‐CoV‐2.What is the most favorite and original chemistry developed in your research group?My favorite chemistries are always those that enable efficient access to drug molecules.How do you get into this specific field? Could you please share some experiences with our readers?The virus uses nucleosides as raw materials for replication. Learned from this biological process, I have been devoted to, for decades, synthesizing nucleoside mimics. Once attached to the 3'‐hydroxy group of the virus RNA chain, these nucleoside analogs can effectively inhibit virus replication. Hard work pays off! We have developed a series of novel 4’‐modified nucleosides, among which Azvudine has been officially approved for treating HIV in China and COVID‐19 in both China and Russia. Notably, Azvudine is the first Chinese oral anti‐COVID‐19 agent. The experiences I would like to share with the readers are many, but emphases are placed on thinking critically and working enthusiastically.How do you supervise your students?I generally supervise students differently according to their aptitudes. For those keen on scientific work, I always suggest them learn from the literature, and practice makes perfect, think critically, and work with passion.What is the most important personality for scientific research?The personalities such as curiosity, creativity, persistence, and the ability to think critically and solve problems matter most for scientific research. Furthermore, what sets successful scientists apart is their passion for their work and their ability to persevere in facing challenges and setbacks.Who influences you mostly in your life?My Ph.D. supervisor profoundly fuels my passion for academia and, to some extent, reshapes my personality.

Meta-analysis: reducing the recurrence rate of allergic rhinitis through oral administration of traditional Chinese medicine.

A systematic review and meta-analysis were carried out to investigate the medical evidence of oral Chinese herbal medicine in reducing the recurrence of allergic rhinitis (AR). Through computer retrieval of PubMed, ScienceDirect, WOS, and other databases, relevant randomized controlled literature was obtained based on the inclusion criteria and retrieval strategies. The retrieval time was set from January 1, 2013, to December 31, 2022. The bias of the literature was evaluated using the bias evaluation module in Cochrane Manual Version 5.1.0, and the meta-analysis was conducted using RevMan software to verify the effectiveness of oral administration of traditional Chinese medicine (TCM) and its impact on reducing the recurrence rate. The meta-analysis included 7 articles. In the meta-analysis of all articles, the effective treatment rate of oral administration of TCM reached 97.09%. Additionally, when comparing the recurrence rate of AR between patients taking Chinese medicine orally and other treatment groups, the recurrence rate of patients taking Chinese medicine orally was only 24.46%, which was significantly lower (p<0.05). Furthermore, the quality of life of patients taking Chinese medicine orally after treatment was significantly higher than that of patients in the control group (C), indicating the good safety of oral Chinese medicine. Oral administration of TCM has demonstrated an effective reduction in the recurrence rate of AR, offering patients a good prognosis. This finding holds significant value for the clinical diagnosis and treatment of AR.

Integrated network pharmacology analysis and in vitro validation revealed the underlying mechanism of Xiyanping injection in treating coronavirus disease 2019.

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, leading to a pandemic. In China, Xiyanping injection (XYP) has been recommended as a drug for COVID-19 treatment in the Guideline on Diagnosis and Treatment of COVID-19 by the National Health Commission of the People Republic of China and National Administration of Traditional Chinese Medicine (Trial eighth Edition). However, the relevant mechanisms at the molecular-level need to be further elucidated. In this study, XYP related active ingredients, potential targets and COVID-19 related genes were searched in public databases. Protein-protein interaction network and module analyzes were used to screen for key targets. gene ontology and Kyoto encyclopedia of genes and genomes were performed to investigate the potentially relevant signaling pathways. Molecular docking was performed using Autodock Tools and Vina. For the validation of potential mechanism, PolyI:C was used to induce human lung epithelial cells for an inflammation model. Subsequently, CCK-8 assays, enzyme-linked immunosorbent assay, reverse transcription quantitative polymerase chain reaction and western blot were employed to determine the effect of XYP on the expression of key genes. Seven effective active ingredients in XYP were searched for 123 targets in the relevant databases. Furthermore, 6446 COVID-19 disease targets were identified. Sodium 9-dehydro-17-hydro-andrographolide-19-yl sulfate was identified as the vital active compounds, and IL-6, TNF, IL-1β, CXCL8, STAT3, MAPK1, MAPK14, and MAPK8 were considered as the key targets. In addition, molecular docking revealed that the active compound and the targets showed good binding affinities. The enrichment analysis predicted that the XYP could regulate the IL-17, Toll-like receptor, PI3K-Akt and JAK-STAT signaling pathways. Consistently, further in vitro experiments demonstrated that XYP could slow down the cytokine storm in the lung tissue of COVID-19 patients by down-regulating IL-6, TNF-α, IL-1β, CXCL8, and p-STAT3. Through effective network pharmacology analysis and molecular docking, this study suggests that XYP contains many effective compounds that may target COVID-19 related signaling pathways. Moreover, the in vitro experiment confirmed that XYP could inhibit the cytokine storm by regulating genes or proteins related to immune and inflammatory responses.

Efficacy and safety evaluation of Azvudine in the prospective treatment of COVID-19 based on four phase III clinical trials.

Azvudine (FNC) is a synthetic nucleoside analog used to treat adult patients living with human immunodeficiency virus-1 (HIV-1) infection with high viral load. After phosphorylation, Azvudine inhibits RNA-dependent RNA polymerase, leading to the discontinuation of RNA chain synthesis in viruses. In addition, Azvudine is the first dual-target nucleoside oral drug worldwide to simultaneously target reverse transcriptase and viral infectivity factors in the treatment of HIV infection. On 9 August 2022, Azvudine was incorporated into the Guidelines for the Diagnosis and Treatment of Coronavirus Disease 2019 (version ninth) issued by the National Health Commission and the National Administration of Traditional Chinese Medicine. The recommended oral dose of Azvudine for the treatment of moderate coronavirus disease 2019 (COVID-19) is 5mg once daily, and the duration of Azvudine treatment should not exceed 14days. Four phase III clinical trials were performed during 2020-2022 to evaluate the efficacy and safety of Azvudine in the treatment of COVID-19. The results revealed that Azvudine could reduce nucleic acid-negative conversion time, viral load, and time to improvement in clinical conditions in patients with moderate COVID-19. In addition, Azvudine exhibited good safety and tolerance. Thereafter, Azvudine was incorporated into the Chinese guidelines and expert consensus for the treatment of COVID-19 and was highly approbated. Furthermore, Azvudine was also included in the Chinese guidelines for HIV infection.

Subtitling Translation of Foreign Propaganda Documentaries from the Perspective of Multimodal Discourse Analysis

As an important component of Chinese culture, traditional Chinese medicine (TCM) is receiving increasing attention in the world. Documentary is a multimodal communication medium that integrates elements such as text, image, sound, animation, and so on, effectively promoting the international dissemination and development of TCM culture. Based on the theoretical framework of multimodal discourse analysis by Delu Zhang, taking the documentary Our Traditional Chinese Medicine released by the National Administration of Traditional Chinese Medicine as an example, this paper analyzes the subtitling translation of the documentary from the cultural, textual, expressive aspects, and the aspect of content, and explores the use of language, image, voice, action and other modes and their cooperation. The result shows that the subtitling translation of Our Traditional Chinese Medicine utilizes multiple modalities to enhance the expressiveness and logic of documentaries, thereby improving the effectiveness of external dissemination.

Effect of microneedle roller on promoting transdermal absorption of crossbow-medicine liquid via transdermal administration of Traditional Chinese Medicine and the safety of crossbow-medicine needle therapy: An experimental study

Ethnopharmacology relevanceCrossbow-medicine needle therapy (microneedle roller combined with crossbow-medicine) is one of the external treatment methods of Miao Medicine in China. It is a way of combining acupuncture with Chinese herbal medicine, which is widely used in clinical treatment of pain. Aim of the studyTo observe the transdermal absorption promoting effect of microneedle roller via transdermal administration, and to discuss the transdermal absorption characteristics and the safety of crossbow-medicine needle therapy. MethodsBased on the determination of the content of the main components of crossbow-medicine prescription in our previous research, the present experiment was conducted in-vitro and in-vivo experiments and the skin of rats was used as the penetration barrier. For in-vitro experiment, the modified Franz diffusion cell method was used to determine the transdermal absorption rate and 24h cumulative transdermal absorption amount of the active ingredients of crossbow-medicine liquid. For in-vivo experiment, tissue homogenization was applied to compare the skin retention amount and plasma concentration of crossbow-medicine liquid absorbed at different time points via the aforementioned two modes of administration. Furthermore, the effect of crossbow-medicine needle on the morphological structure of rat skin stratum corneum was detected by hematoxylin-eosin (HE) staining. The safety of crossbow-medicine needle therapy was evaluated according to the scoring criteria of the skin irritation test. Results1. In-vitro experiment: In the microneedle-roller group and crossbow-medicine liquid application group, the effect of transdermal delivery was identified in all the four ingredients of anabasine, chlorogenic acid, mesaconitine and hypaconitine. The 24h cumulative transdermal absorption amount and transdermal absorption rate of each ingredient in microneedle-roller group were significantly higher than those in crossbow-medicine liquid application group (all P < 0.05). 2. In-vivo experiment: Both microneedle-roller and crossbow-medicine liquid application could promote the transdermal absorption of the active ingredients of the drug in the skin and retain in the skin structure. After 8h of administration, the total retention amount of anabasine, chlorogenic acid, mesaconitine and hypaconitine in the skin of rats in the former group was significantly higher than that in the latter group (all P < 0.05). 3. HE staining: In the blank group, the stratum corneum showed an evenly zonal distribution on the active epidermis, and had a close connection with the epidermis, without exfoliation or cell dissociation of the stratum corneum. The crossbow-medicine liquid group had a relatively complete stratum corneum, with a small proportion of exfoliation or cell dissociation, loose arrangement and loose connection with the epidermis. In the microneedle-roller group, the skin had pore channels, and the stratum corneum was loose and exfoliated, which showed zonal distribution in a free state and a high degree of separation. The crossbow-medicine needle group had loose the stratum corneum, broken and exfoliated, which was separated from the active epidermis and showed zonal distribution in a free state. 4.Safety: No obvious erythema, edema and skin protuberance were observed in the skin of rats treated with microneedle roller, crossbow-medicine liquid and crossbow-medicine needle. Additionally, the skin irritative response score was 0. ConclusionMicroneedle roller can promote the transdermal absorption of crossbow-medicine liquid, and crossbow-medicine needle therapy has good safety.

WHO International Standard Terminologies on Traditional Chinese Medicine: Use in Context, Creatively

WHO International Standard Terminologies on Traditional Chinese Medicine: Use in Context, Creatively

Correlation Analysis of Traditional Chinese Medicine Syndrome Types and Influencing Factors of Asthmatic Bronchitis in Children

Objective: To explore the correlation between traditional Chinese medicine (TCM) syndrome types and the influencing factors of asthmatic bronchitis in children, as well as to provide clinical syndrome differentiation basis and reference for the treatment of children with asthmatic bronchitis. Methods: The clinical data of 197 inpatients with asthmatic bronchitis in our hospital from March 2021 to March 2022 were collected, referring to “Zhu Futang Practical Pediatrics” (7th Edition, 2002) and “Chinese Medicine Industry Standards – Standards for Diagnosis and Efficacy of Pediatric Diseases and Syndromes of Traditional Chinese Medicine” (1994, State Administration of Traditional Chinese Medicine) for diagnosis, classification, and analysis of TCM syndrome types and the influencing factors of asthmatic bronchitis in children. Results: (i) cold asthma syndrome contributed to the majority of TCM syndrome types of pediatric asthmatic bronchitis; (ii) gender had a great influence on TCM syndromes types in children with asthmatic bronchitis, and the differences among the TCM syndrome types were statistically significant (P &lt; 0.05); (iii) there was no significant difference in the distribution of TCM syndrome types of pediatric asthmatic bronchitis among different age groups (P &gt; 0.05); (iv) birth status had no effect on the distribution of TCM syndrome types of pediatric asthmatic bronchitis (P &gt; 0.05); (v) no significant correlation was observed between the mode of delivery and the distribution of TCM syndrome types in children with asthmatic bronchitis (P &gt; 0.05); (vi) children with cold asthma syndrome, heat asthma syndrome, and mixed cold and heat syndrome were not breastfed, and there was no significant difference in the feeding methods of children with mixed deficiency and excess syndrome (P &gt; 0.05); (vii) no significant correlation was observed between the TCM syndrome types of pediatric asthmatic bronchitis and family history of asthma/allergy (P &gt; 0.05); (viii) a significant correlation was observed between different TCM syndrome types and history of drug and food allergy (P &lt; 0.05); (ix) normal or high eosinophil percentage was commonly observed in children with asthmatic bronchitis, and there was no significant difference among the different TCM syndrome types (P &gt; 0.05). Conclusion: The TCM syndrome types of pediatric asthmatic bronchitis are related to gender, feeding history, allergy history, and other factors, which may be influencing factors of the TCM syndrome types of pediatric asthmatic bronchitis.

Thermal immuno-nanomedicine: A new strategy for cancer treatment.

Thermal immuno-nanomedicine: A new strategy for cancer treatment.

Exploring the mechanism of Taohong Siwu Decoction on the treatment of blood deficiency and blood stasis syndrome by gut microbiota combined with metabolomics

BackgroundTaohong Siwu Decoction (THSWD) is a prescription which included in the “List of Ancient Classic Prescriptions (First Batch)” issued by the National Administration of Traditional Chinese Medicine (TCM) and the National Medical Products Administration of the People’s Republic of China. THSWD is effective and widely applied clinically for many diseases caused by blood deficiency and stasis syndrome in TCM, such as primary dysmenorrhea, menopausal syndrome, coronary heart disease, angina pectoris, and diabetes.MethodsThe TCM model of blood deficiency and blood stasis syndrome was prepared by ice water bath combined with cyclophosphamide, and the rats were randomly divided into control group, blood deficiency, and blood stasis model group, positive group, and THSWD treatment group. Pharmacodynamics measured the blood routine, blood coagulation, and other related indexes in rats. UHPLC-MS technology was used to analyze the changes in the fingerprints of metabolites in the plasma of rats with blood deficiency and blood stasis syndrome, and combined with mass spectrometry information and public database retrieval, to find potential biomarkers for screening metabolites. At the same time, 16S rDNA sequencing technology was used to identify intestinal flora, and statistical analysis was used to find differences in strain diversity between groups.ResultsTHSWD administration can significantly improve the physical signs, blood routine, and hematopoietic factors caused by the blood deficiency and blood stasis syndrome model, and improve the symptoms of blood deficiency. The results of the general pharmacological studies showed THSWD groups improved changes in blood plasma viscosity and coagulation-related factors caused by modeling, and improved coagulation function significantly. The metabolomic analysis found that compared to the model group, THSWD exerted better effects on β-alanine, taurine, l-tyrosine, l-arginine, Eugenol, sodium deoxycholate, and deethylatrazine. Twenty-three potential differential metabolites showed intervention effects, mainly involved in eight metabolic pathways, including amino acid metabolism, taurine and hypotaurine metabolism, vitamin metabolism, and nucleotide metabolism. Gut microbiota data showed that, compared to the control group, the relative abundance and value of Firmicutes and Bacteroidota of the blood deficiency and blood stasis model group was significantly reduced, while the relative abundance of Actinobacteria, Spirochaetota, Proteobacteria, Campilobacterota, and other pathogenic bacteria was significantly increased. Following THSWD intervention, the abundance of beneficial bacteria increased, and the abundance of pathogenic bacteria decreased. Correlation analysis between the gut microbiota and differential metabolites showed that the two are closely related. THSWD affected the host blood system through mutual adjustment of these two factors, and improved blood deficiency and blood stasis syndrome in rats.ConclusionThe blood deficiency and blood stasis syndrome model of TCM disease caused by ice bath combined with cyclophosphamide lead to changes in the pharmacology, metabolomics, and gut microbiota. The intervention of THSWD can improve the symptoms caused by blood deficiency and blood stasis. The mechanism is mainly through the regulation of platelet function and amino acid metabolism.

World Health Organization survey on the level of integration of traditional Chinese medicine in Chinese health system rehabilitation services

BackgroundTo meet the growing global demand for rehabilitation services, the World Health Organization (WHO) launched Rehabilitation 2030. This study was commissioned by the WHO to investigate the integration degree of traditional Chinese medicine (TCM) in Chinese health system rehabilitation services and the demand for TCM rehabilitation in China. MethodsTwenty TCM rehabilitation experts and relevant government administrators were invited to complete the questionnaire between September 2019 and January 2022. The development of traditional, complementary, and integrative medicine (TCI) rehabilitation in China was assessed primarily based on six different health system components. Results26 policies, regulations, and national strategic plans related to TCI rehabilitation were issued by relevant government departments since 2002; notably, 14 policies related to TCI rehabilitation development were intensively introduced from 2016 to 2021. These policies cover the three main areas of financing, infrastructure development, and service delivery. The National Administration of Traditional Chinese Medicine's investment in TCM clinical capacity infrastructure and scientific research in 2019–2021 increased by 66% compared to 2010–2012, and the average number of TCM hospitals with rehabilitation departments in 2020 increased by 6.5% compared to 2018. The proportion of community health service centers providing TCM services in primary medical and health institutions has increased by 30.8% over the past 10 years. ConclusionLong-term continuous policies, substantial financial investment, and expansion of the scope of TCI rehabilitation services in primary care institutions have effectively contributed to the rapid development of TCI rehabilitation. However, human resources and financing mechanisms for TCI rehabilitation need further improvement.

Diagnosis and treatment protocol for COVID‐19 patients (Tentative 10th Version)

AbstractTo further improve the diagnosis and treatment of COVID‐19, the National Health Commission of People's Republic of China and the National Administration of Traditional Chinese Medicine convened a group of experts to revise the relevant content of the Diagnosis and Treatment Protocol for COVID‐19 Patients (Trial Version 9) and developed the Diagnosis and Treatment Protocol for COVID‐19 Patients (Trial Version 10), summarizing the etiological characteristics, epidemiological characteristics, prevention, clinical features, diagnosis, clinical classification, population with high risk of severe/critical illnesses, early warning predictors for severe/critical illnesses, differential diagnosis, case identification and reporting, treatment, nursing, control of nosocomial infection in medical institutions, and discharge criteria for inpatients.

Translation: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10)

National Health Commission of the People's Republic of China, National Administration of Traditional Chinese Medicine This is a document released by National Health Commission of the People's Republic of China and National Administration of Traditional Chinese Medicine. The original file is available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a/files/02ec13aadff048ffae227593a6363ee8.pdf The material was translated by the Infectious Microbes & Diseases Editorial Office. Conflicts of interest: The authors reported no conflicts of interest. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Clinical efficacy of combination therapy of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs in the treatment of novel coronavirus pneumonia: A prospective interventional study

IntroductionThe National Administration of Traditional Chinese Medicine of the People’s Republic of China (NATCM) and the State Administration of Traditional Chinese medicine (TCM) advocated a combination therapy of TCM and anti-viral drugs for novel coronavirus pneumonia (NCP) to improve the efficacy of clinical treatment. MethodsForty-six patients diagnosed with NCP were sequentially divided into intent-to-treat population: the experimental group (combination of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs; n = 23) and the control group (anti-viral drugs only) (n = 23). The two groups were compared in terms of duration of fever, cough symptom score, fatigue, appetite, dyspnea, out-of-bed activities, chest computer tomography (CT) recovery, virological clearance, average length of hospital stay, and clinical effective rate of drug. After 6 days of observation, patients from the control group were divided into as-treated population: experimental subgroup (n = 14) to obtain clinical benefit and control subgroup (n = 9). ResultsThere was a significant improvement in the duration of fever (1.087 ± 0.288 vs 4.304 ± 2.490), cough (0.437 ± 0.589 vs 2.435 ± 0.662; P < 0.05), chest CT evaluation (82.6% vs 43.4%; P < 0.05), and virological clearance (60.8% vs 8.7%; P < 0.05) in patients of the experimental group compared with patients in the control group. Further observation in as-treated population reported that cough (0.742 ± 0.463 vs 1.862 ± 0.347; P < 0.05) and fatigue (78.5% vs 33.3%; P < 0.05) were significantly relieved after adding FuXi-Tiandi-Wuxing Decoction to the existing treatment. ConclusionAn early treatment with combination therapy of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs significantly relieves the clinical symptoms of NCP, shows improvement in chest CT scan, improves virological clearance, shortens average length of hospital stay, and reduces the risk of severe illness. The effect of FuXi-Tiandi-Wuxing Decoction in NCP may be clinically important and require further consideration.