Clinical Efficacy Of Traditional Chinese Medicine Research Articles

Use of Chinese Herbal Medicine to Inhibit Podocyte Damage as Therapeutic Strategy for Membranous Nephropathy

ABSTRACT Membranous nephropathy (MN), one of the most common glomerular diseases, is a noninflammatory autoimmune podocyte disease. In the body, podocytes play an important role in maintaining the stability of the glomerular filtration barrier, and the degree of podocyte damage is a major determinant of MN prognosis because of the limited ability of podocytes to repair and regenerate. Although several therapeutic modalities for inhibiting podocyte damage are currently available, most lead to adverse, nonspecific systemic effects; therefore, newer drugs are necessary to target podocyte damage in MN. Traditional Chinese medicine (TCM) plays an important role in the treatment of primary MN in China. This study reviews the role of podocytes and the mechanisms of podocyte injury in MN glomeruli and summarizes the current status of complement-mediated therapy, the clinical efficacy of TCM in the treatment of primary MN, and the potential mechanisms regulating podocyte injury to support the development of new therapeutic strategies.

Extracellular vesicles from medicated plasma of Buyang Huanwu decoction-preconditioned neural stem cells accelerate neurological recovery following ischemic stroke.

Introduction: The neurological impairment of survivors after ischemic stroke poses a serious risk to their quality of life and health. Effective therapeutic options are still lacking. Neural stem cells (NSCs) promote neurogenesis via secreted extracellular vesicles (NSC-EVs), which would be a potential therapeutic option, but the insufficient quantity of NSC-EVs in vivo restrains clinical application. Buyang Huanwu Decoction (BHD), a classic traditional Chinese medicine (TCM) decoction, is promising to alleviate neurological impairment after ischemic stroke. It was speculated that BHD might promote neurological recovery through the NSC-EVs. Methods: The medicated plasma of BHD (MP-BHD) was prepared to precondition NSCs and isolate EVs (BHD-NSC-EVs). Middle cerebral artery occlusion (MCAO) models and primary NSCs were administered to evaluate the therapeutic effect. Next-generation sequencing was performed to explore the mechanism. Results: The BHD-NSC-EVs more significantly accelerated neurological recovery after MCAO and promoted NSCs proliferation and differentiation than BHD and NSC-EVs alone. MP-BHD enhanced the largescale generation of BHD-NSC-EVs, which encapsulated functional miRNA and may play critical roles in neurogenesis. Discussion: In replacing BHD or NSCs, the preconditioned NSC-EVs present a more efficient therapeutic strategy for ischemic stroke. Based on the clinical efficacy of TCM, the preconditioning of NSC-derived EVs via the MP of TCM herbs would presents a newly promising therapeutic strategy for neurological diseases.

Traditional Chinese medicine microbiomics and its research strategies

The tight relationships between microbiome and traditional Chinese medicine(TCM)have been widely recognized. New technologies, results, and theories are emerging in the field of microbiomics in recent years with the advances in high-throughput sequencing and multi-omics technologies. Based on the previous research, the present study has proposed the concept of TCM microbiomics(TCMM), which is an interdisciplinary subject aiming at elucidating the functions and applications of microbiome in the areas of herb resources, herb processing, herb storage, and clinical effects by using modern technology of biology, ecology, and informatics. This subject essentially contains the structures, functions, interactions, molecular mechanisms, and application strategies of the microbiome associated with the quality, safety, and efficacy of TCM. Firstly, the development of the TCMM concept was summarized, with the profound understanding of TCMM on the complexity and entirety of microbiome being emphasized. Then, the research contents and applications of TCMM in promoting the sustainable development of herb resources, improving the standardization and diversification of herb fermentation, strengthening the safety of herb storage, and resolving the scientific connotation of theories and clinical efficacy of TCM are reviewed. Finally, the research strategies and methods of TCM microbiomics were elaborated from basic research, application research, and system research. TCMM is expected to promote the integrative development of TCM with frontier science and technology, thereby expanding the depth and scope of TCM study and facilitating TCM modernization.

Traditional Chinese Medicine in Treating Primary Podocytosis: From Fundamental Science to Clinical Research.

Podocytes form a key component of the glomerular filtration barrier. Damage to podocytes is referred to as “podocyte disease.” There are many causes of podocyte injury, including primary injury, secondary injury, and gene mutations. Primary podocytosis mostly manifests as nephrotic syndrome. At present, first-line treatment is based on glucocorticoid administration combined with immunosuppressive therapy, but some patients still progress to end-stage renal disease. In Asia, especially in China, traditional Chinese medicine (TCM) still plays an important role in the treatment of kidney diseases. This study summarizes the potential mechanism of TCM and its active components in protecting podocytes, such as repairing podocyte injury, inhibiting podocyte proliferation, reducing podocyte apoptosis and excretion, maintaining podocyte skeleton structure, and upregulating podocyte-related protein expression. At the same time, the clinical efficacy of TCM in the treatment of primary podocytosis (including idiopathic membranous nephropathy, minimal change disease, and focal segmental glomerulosclerosis) is summarized to support the development of new treatment strategies for primary podocytosis.

Urgent need for medical institutions to develop traditional Chinese medicine decoction pieces prescription-based processing and related suggestions

As the last procedure of traditional Chinese medicine(TCM) applied in clinical practice, prescription-based processing(PBP) is an important guarantee for the quality and clinical efficacy of TCM, which can not only maximize the effect of processed product, but also exert the characteristics of syndrome differentiation and treatment in TCM. However, due to various reasons, most medical institutions have no PBP business. As a result, doctors can only use the conventional decoction pieces available on the market, which also greatly limits their flexible medication, with certain impacts on the normal development of the curative effect of TCM. Therefore, the article explained the necessity of PBP from three aspects. In addition, according to Chinese Pharmacopoeia and the characte-ristics of TCM decoction pieces, the varieties suitable for PBP were summarized and proposed, and also some suggestions about developing PBP are given. The PBP is one of the characteristic techniques in TCM, with special technical requirements and profound scientific connotation. The development of PBP will not only promote the processing of TCM and ensure the clinical efficacy, but also promote the vigorous development of TCM.

A Series of N-of-1 Trials for Traditional Chinese Medicine Using a Bayesian Method: Study Rationale and Protocol.

Background. Our previous studies showed that N-of-1 trials could reflect the individualized characteristics of traditional Chinese medicine (TCM) syndrome differentiation with good feasibility, but the sensitivity was low. Therefore, this study will use hierarchical Bayesian statistical method to improve the sensitivity and applicability of N-of-1 trials of TCM. Methods/Design. This is a randomized, double-blind, placebo-controlled, three-pair crossover trial for a single subject, including 4–8 weeks of run-in period and 24 weeks of formal trial. In this study, we will recruit a total of 30 participants who are in the stable stage of bronchiectasis. The trial will be divided into three pairs (cycles), and one cycle contains two observation periods. The medications will be taken for three weeks and stopped for one week in the last week of each observation period. The order of syndrome differentiation decoction and placebo will be randomly determined. Patient self-reported symptom score (on a 7-point Likert scale) is the primary outcome. Discussion. Some confounding variables (such as TCM syndrome type and potential carryover effect of TCM) will be introduced into hierarchical Bayesian statistical method to improve the sensitivity and applicability of N-of-1 trials of TCM, and the use of prior available information (e.g., “borrowing from strength” of previous trial results) within the analysis may improve the sensitivity of the results of a series of N-of-1 trials, from both the individual and population level to study the efficacy of TCM syndrome differentiation. It is the exploration of improving the objective evaluation method of the clinical efficacy of TCM and may provide reference value for clinical trials of TCM in other chronic diseases. This trial is registered with ClinicalTrials.gov (ID: NCT04601792).

Targeting Protein Kinase Inhibitors with Traditional Chinese Medicine.

Protein kinases play critical roles in the control of cell growth, proliferation, migration, and angiogenesis, through their catalytic activity. Over the past years, numerous protein kinase inhibitors have been identified and are being successfully used clinically. Traditional Chinese medicine (TCM) represents a large class of bioactive substances, and some of them display anticancer activity via inhibiting protein kinases signal pathway. Some of the TCM have been used to treat tumors clinically in China for many years. The p38mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase, serine/threonine-specific protein kinases (PI3K/AKT/mTOR), and extracellular signal-regulated kinases (ERK) pathways are considered important signals in cancer cell development. In the present article, the recent progress of TCM that exhibited significant inhibitory activity towards a range of protein kinases is discussed. The clinical efficacy of TCM with inhibitory effects on protein kinases in treating a tumor is also presented. The article also discussed the prospects and problems in the development of anticancer agents with TCM.

Impact on evaluation of clinical efficacy of traditional Chinese medicine for level in soft targets of processing technology

Traditional Chinese medicine (TCM) is a very practical subject, which has its unique theoretical system and clinical characteristics. In the course of clinical practice, the exact clinical efficacy is the key of existence and development. But the existing evaluation system is difficult to objectively evaluate the clinical efficacy of TCM. Therefore, how to objectively evaluate the clinical efficacy and get definitive evidence is the focus of the evaluation of clinical efficacy of TCM. Relative to modern medicine, TCM is more concerned about the changes of feelings and clinical symptoms of the patient in the course of the evolution of the disease. Soft targets mainly used for the evaluation of the clinical efficacy of symptoms and functional activity of the disease. The level in soft targets of processing technology is often used methods in clinical evaluation. But it has often produced the phenomenon which the results of the evaluation is mutual contradiction, which will ultimately affect the effect of evaluation of clinical efficacy of TCM. In order to better evaluate the clinical efficacy of TCM, in the process of adoption of soft targets, it clearly identify it's role, highlighting the characteristics of interventions on disease, and as much as possibly avoid the level in soft targets of processing technology to real assess clinical efficacy of TCM.

Quality Evaluation of Semen Oroxyli Based on the Determination of Multiple Components with a Single Reference Standard

The determination of multiple components is considered to be one of the key methods to control the quality of traditional Chinese medicine (TCM), because the clinical efficacy of TCM is derived from the synergistic action of multi-components. When simultaneously determining multi-components in TCM with multiple reference standards (MRS), the limited availability and high expense of various reference standards is a major obstacle. Currently, a practical method determining multi-components with a single reference standard (SRS) is needed to solve the problem, in which the contents of those components without reference standards can be calculated using relative conversion factor. In the present paper, both MRS and SRS methods were established for the simultaneous quantitative determination of seven bioactive flavonoids in Muhudie (MHD), the seed of Oroxylum indicum L., a traditional Chinese herb that has been used for centuries. Forty samples were assayed and data obtained from the two methods were compared, and no statistically significant difference was observed by a T-test (P > 0.05), thus, the SRS method can be applied for quality analysis of MHD. At the same time, a certain correlation was discovered between the contents of the bioactive components and the morphological character of MHD.

Prospect on the Composite Drugs Innovation System

Abstract With the analysis of opportunities and challenges for the drug innovation, this research proposed a definition of the composite drug, which means a compatible combination of multiple compounds or multi-group compounds developed under the guidance of multiple therapeutic principles and mechanisms in order to achieve an optimal holistic efficacy. Composite drugs may consist of composite Traditional Chinese Medicine (TCM) and composite synthetic drugs or the combination of the both. The characteristics of composite drug innovation system are the followings: first, its target is the patient, not just a particular disease. Second, it requires the collaboration from physicians and the combination of iatrology and pharmacology. Third, it requires an R&D procedure of clinical experience to animal experiment to clinical trial. Fourth, it requires the development of a comprehensive assessment system for the clinical efficacy. Fifth, it requires developing an integrative system for screening of composite drugs. Sixth, it requires a development of an integrative system with both holistic characterization and specific characterization of the pharmaceutical components group. The current key issues for the innovation of composite TCM drugs are to develop a comprehensive assessment system for the clinical efficacy of TCM, to develop an integrative system for screening of composite drugs according to the characteristics of TCM and to standardize the approaches for the integrative characterizing of composite drugs. As in some demonstrative studies, this research has developed a new approach, Chemomics-integrated Global System Biology based on which a few composite drugs have been developed: one for treatment of ischemic apoplexy using TCM Qingkailing, and another one for treatment of ischemic cardiopathy using TCM Shuanglongfang. The current key issues for the innovation of composite synthetic drugs should focus on how to innovate the notions in order to establish an acknowledged model for the innovation of composite synthetic drugs, to attract physicians to participate in the composite drug innovation in order to establish an R&D procedure of clinical experience to animal experiment to clinical trial, and to strengthen the research of the composite drugs combining TCM and synthetic drugs.

Acupuncture Treatment for Gastroparesis

ABSTRACT Background: Gastroparesis is a digestive disorder in which the motility of the stomach is either abnormal or absent. Symptoms include, but are not limited to, a feeling of fullness after only a few bites of food, bloating, excessive belching, and nausea. Traditional Chinese Medicine (TCM) has been used to treat a wide variety of visceral disorders. Objective: To evaluate the clinical efficacy of TCM in treating patients with gastroparesis. Design, Setting, and Patient: Single case (a 61-year-old woman with a 2-year history of gastroparesis) presented to Southern California University Health Center (Whittier, CA) in June 2005. She was followed up through Fall 2005. Intervention: The treatment protocol for her digestive disorder included acupuncture treatment twice a week on Ren 14 and ST 36, and the administration of traditional Chinese herbal formula Xiao Ban Xia Jia Fu Ling Tang. Main Outcome Measures: Gastric emptying test and patient report of symptoms. Results: The patient reported significan...