Guidance Of Traditional Chinese Medicine Theory Research Articles

Integration of network pharmacology with experimental validation to reveal the mechanism of action of Longdan Xiegan Decoction against HSV2 infection and determine its effective components

Ethnopharmacological relevanceTraditional Chinese Medicine (TCM) has made enormous strides recently in the discovery of anti-herpes simplex virus (HSV) drugs under the guidance of TCM theory. Longdan Xiegan Decoction (LXD), a formulation recorded in the Pharmacopoeia of the People's Republic of China, has proved to be effective against HSV infection. However, its effective components and action mechanism remain unclear. Aim of the studyTo investigate the effective components and mechanisms of LXD in treating HSV infection based on network pharmacology and experimental validation. Materials and methodsThe anti-HSV activities of key compounds predicted by network analysis were detected by antiviral tests. High-performance liquid chromatography (HPLC) was applied to identify the main components of the LXD aqueous extract. Time-of-addition assay and infectivity inhibition reversibility assay were conducted to identify the potential antiviral mechanisms of licochalcone B (LCB). Additionally, we assessed the antiviral effect of LCB in vivo by use of body weight, viral load, histological analysis, and scoring of genital lesions in an HSV2-infected mouse model. ResultsOur data demonstrated that some components exhibited significant anti-HSV1/2 activity in vitro, including quercetin, kaempferol, wogonin, formononetin, naringenin, baicalein, isorhamnetin, glabridin, licochalcone A, echinatin, oroxylin A, isoliquiritigenin, pinocembrin, LCB and acacetin. HPLC analysis showed that LCB was the main component of LXD aqueous extract. In vitro experiments revealed that LCB not only inactivated HSV2 particles, but also inhibited HSV2 multiplication through the inhibition of the phosphorylation of Akt and its downstream targets. In vivo experiments confirmed that LCB could significantly reduce viral titer, delay weight loss, and alleviate pathological changes in vaginal tissue in vaginal infection mouse models. ConclusionLCB acted as the main component of LXD, with significant anti-HSV2 infection effects both in vivo and in vitro. This study provides additional evidence of the healing efficacy of LXD against HSV infection and presents an efficient analytical method for further investigation of the mechanisms of TCM in prevention and treatment of various diseases.

Narrative Medicine under the Guidance of Traditional Chinese Medicine Theory

This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine (TCM). By adopting the theory of TCM, the author attempted to provide the patients with systematic treatment from the perspective of society-psychology-biology under the guidance of both the unity of heaven and man, and the unity of Xing (形Body) and Shen (神Mind/Spirit) through his clinical practice. Guided by Yin Yang（阴阳） and Wu Xing (五行Five Elements) theory and focusing on the social relations of the patients for any possible relationships between patients’ social, psychological and biological state, the author took the patients’ emotion management as a point of departure and helped the patients recover both physically and psychologically by promoting positive transformation in patients’ social, psychological and biological state. A clinical case was provided at the end of this paper to demonstrate how the above theory was put into practice. Narrative medicine under the guidance of TCM theory can supplement modern medical humanity practices as well as extend the scope of modern medical treatment from the perspective of the unity of heaven and man, by enriching the content of narrative medicine and promoting the medical model from biological medical model toward social-psychological-biological model.

[Application of traditional Chinese medicine theory in modern traditional Chinese medicine nano-preparation: taking tumor treatment as an example].

With Zang-Fu organs, meridians, Qi and blood, and body fluid as the physiological and pathological basis, traditional Chinese medicine(TCM) theory is guided by the holistic concept and characterized by syndrome differentiation. It has made significant contributions to human health maintenance and disease prevention. Modern TCM preparation is developed on the basis of inheriting and developing TCM preparations using modern science and technology under the guidance of TCM theory. At present, the incidence and mortality of common tumors are increasing. TCM has rich clinical experience in the treatment of tumors. However, in the current stage, some TCM preparations have a tendency to deviate from the guidance of TCM theory. With the modernization of TCM, it is worth considering how TCM theory guides modern TCM preparations. Taking tumor treatment as an example, this paper introduced the development of TCM nano-preparation under the influence of modern nanotechnology, summarized the research on the development of modern TCM nano-preparation from the aspects of TCM holistic concept, TCM treatment principles, and TCM theory application, and discussed the application prospect of TCM nano-preparation in overall therapy, drug pairing, carrier selection, and targeted substance selection under the guidance of TCM theory. This paper provides new references for further developing the combination of tradition and modernization of TCM nano-preparation.

Postoperative Effect Observation and Clinical Study of Dahuang Zhechong Pills from Jingui Yaolue in Treating Patients with Early-to-Mid Prostate Cancer Undergoing Radical Resection.

Objective To explore the effect of applying Dahuang Zhechong pills (DHZCP) from Jingui Yaolue to patients with early-to-mid prostate cancer undergoing radical resection and carry out a theoretical clinical study of traditional Chinese medicine (TCM) to verify the effect of DHZCP formula under the guidance of TCM theory. Methods The clinical data of 98 patients with early-to-mid prostate cancer undergoing radical resection treated in our hospital (July 2014 to July 2016) were selected for the retrospective analysis, and the patients were divided into group A (n = 49, routine hormonal therapy) and group B (n = 49, routine hormonal therapy plus DHZCP) according to the double blind method, so as to compare the trauma symptoms, cancer recurrence rate, etc., after treatment between the two groups. Results Compared with group A, group B obtained significantly higher total effective rate of complication treatment at different time points (P < 0.05), significantly lower mean HAMA score after treatment (P < 0.05), and significantly lower total recurrence rate (P < 0.05). The “congestion” theory in Chapter VI On Pulse, Symptom Complex and Treatment of Arthralgia Due to Stagnation of Blood and Consumptive Diseases of Jingui Yaolue was the theoretical basis for postoperative effect observation of DHZCP in treating prostate cancer. Combining with the onset theory of congestion, personally, the author believed that cancer is caused by congestion disease formed by the extravasated blood in the human body, and with the passing of time, the intermingled deficiency, blood stasis, and toxicity lead to the qualitative change of endogenous cancer toxicity and develop into consumptive congestion disease, making it the core pathogenesis of cancer. And DHZCP had good preventive and treatment effect. Conclusion DHZCP is an effective drug for improving postoperative complications of early-to-mid prostate cancer, reducing the biological recurrence rate and clinical recurrence rate, and improving mental status. The formula treats both deficiency and excess, combines tonification with purgation, and dispels exogenous pathogen without damaging body resistance, which is a profound formula based on TCM theory to treat “congestion,” “congestion disease,” and “consumptive congestion disease.” Using this theory to guide clinical syndrome differentiation and treatment and modifying the dosage and usage can play an important role in TCM preventive treatment of cancers, early, middle, and late treatment, and clinical prevention of other chronic diseases.

[Theoretical thinking on guiding research and development of new drugs of traditional Chinese medicine].

This article proposes that the research and development of new Chinese medicines should be based on the clinical values of traditional Chinese medicine(TCM), and expounds the multiple clinical values of new Chinese medicines such as therapeutic effects, adjuvant treatment effects, improvement of disease symptoms, improvement of quality of life, prevention of diseases, etc., so as to broaden the clinical indications of new Chinese medicines. It is pointed out that the clinical value of TCM determines the clinical efficacy evaluation method of new Chinese medicines, so as to construct a clinical evaluation system of new Chinese medicines with the characteristics of TCM. It is proposed that the clinical value of new Chinese medicines should be found under the guidance of TCM theo-ry and clinical practice, and the theoretical innovation of TCM should be emphasized. There is no difference in the clinical value of drugs, and the key is to meet the clinical needs of patients. The research and development of new Chinese medicines ignores the theoretical guidance of Chinese medicine, and relying solely on animal experiment data may lead to failure of clinical trials. Different from the individualized treatment of TCM clinical syndrome differentiation, summarizing the core pathogenesis of TCM is the basis for the development of new Chinese medicines. It is necessary to summarize the pathogenesis of the disease under the guidance of TCM theory and encourage the application of modern medical methods to clarify the diagnosis of the disease. In view of the characteristics of new Chinese medicine research and development, it is proposed that the supporting role of human experience should be emphasized, and the technical points of clinical trials of new syndrome-type Chinese medicines should be explained.The use of objective indicators for syndrome evaluation, the selection of appropriate scales, and the formulation of reasonable treatment courses are advocated. During the research and development of new Chinese medicines, it is not only necessary to pay attention to modern medical safety indicators, but also to observe the evolution of TCM syndromes and specific TCM symptoms.

[Analysis and considerations on revision of instructions for traditional Chinese medicine injections].

According to the notice on revision of the instructions for traditional Chinese medicine injections(TCMIs) issued by the National Medical Products Administration(NMPA) from January 2006 to May 2020, the revised contents in the instructions for 29 varieties involved in the notice were sorted out, and the existing problems in the instructions for TCMIs were analyzed, so as to provide the basis for dynamic revision of the instructions. It was found that the revised items of instructions for 29 varieties all involved adverse reactions, contraindications and precautions, and warnings were added for 82.76% of 29 TCMIs preparations, indicating that all the revised contents were related to safety issues. In addition, 33.33% of the drugs risks mentioned in the precautions were not indicated in the adverse reactions; 82.76% instructions did not indicate drug interactions; 17.24% instructions lacked medication notes for special populations; 48.28% instructions did not indicate traditional Chinese medicine(TCM) syndromes of the main disease; 44.83% instructions did not indicate the type and stage of indication; and 86.21% instructions did not indicate the course of treatment. It could be concluded that the instructions for TCMIs have known risks of drugs that are not fully reflected in adverse reactions and the effective information is not comprehensive. The risk control measures proposed in the precautions need to have aftereffect evaluation and there is a lack of drug interactions and medications for special populations. As an important part of the full life-cycle management of drugs, the revision of instructions for TCMIs should be continuously improved to provide the basis for safe and reasonable application of TCMIs. Based on the above problems, it is proposed that the marketing license holder as the main body of the revision of instructions should actively carry out post-marketing basic and clinical research in accordance with the characteristics of TCM, combine the updated research with the guidance of TCM theory and improve the revision level of instructions for TCMIs to provide the basis for post-marketing evaluation.

[Discovery and application of traditional Chinese medicine efficacy markers based on systematic traditional Chinese medicine].

The quality marker(Q-marker) of traditional Chinese medicine(TCM) is a new concept of TCM quality control proposed in recent years. It is a hot issue in the research of modern Chinese medicine. The TCM efficacy is a high-level summary of the TCM therapeutic effect under the guidance of TCM theory. On this basis, it is of considerable significance to explore the TCM efficacy marker for the TCM modernization. However, the traditional research strategy based on the single herb and decoction piece in macro TCM level, or the drug research strategy based on the biological effect of the targets, is quite different from the characteristics of multiple components of TCM, as well as the weak and low-selective effect of Chinese medicine ingredients on targets. Therefore, how to select representative ingredients to characterize the TCM overall efficacy is a problematic point in establishing TCM efficacy markers. In this paper, the concept and method of Q-marker were introduced into the study of Chinese medicine efficacy. The research method for systematic TCM was used to systematically discuss the connotation of TCM efficacy markers, the principles of discovery and determination, common research ideas and techniques by taking the representative research results as an example. This study provides new ideas for the research and discovery of TCM efficacy markers.

[Pharmacological effect of combined administration of natures, tastes and components of Chinese herbal compounds].

The combined administration of traditional Chinese medicine (TCM) aims at comprehensive adjustment of body based on the theory of TCM and the theory of Chinese medicine property. The natures and tastes of TCM are the core of the theory of TCM property. The combined administration of natures and tastes of TCM is one of the important theories of prescription compatibility. The objective of study on the combined administration of natures and tastes of prescriptions according to symptoms of disease is to clarify the compatibility mechanism of prescriptions. The study on the compound compatibility of TCM under the guidance of theory of TCM focuses on the relationship between the composition, dosage and compatibility of TCM by using modern high-tech means. It demonstrates the effective combination of TCM theory and modern technology, and the inheritance and innovation of TCM theory. The study of the effect and mechanism of compatibility of natures and tastes of TCM under the guidance of TCM theory is helpful for the analysis of the compatibility effect and mechanism of TCM based on the pharmacological effect of natures and tastes of TCM. The correlation between the pharmacological effect of natures and tastes of TCM and the pharmacological effect of components were studied by modern informatics, which is beneficial to promote the development of theory of TCM compound. The study of the compatibility between natures, tastes and component of TCM shall pay attention to the combination of pharmacological effects of natures, tastes and component of TCM, so as to define the scientific connotation of the compatibility of TCM, and make full use of the characteristics and advantages of TCM. The methods and pharmacological effects of the combined administration of TCM compounds are reviewed to provide the theoretical basis for the development of new drugs and clinical application.

Development of models for classification of action between heat-clearing herbs and blood-activating stasis-resolving herbs based on theory of traditional Chinese medicine

BackgroundAction (“gongxiao” in Chinese) of traditional Chinese medicine (TCM) is the high recapitulation for therapeutic and health-preserving effects under the guidance of TCM theory. TCM-defined herbal properties (“yaoxing” in Chinese) had been used in this research. TCM herbal property (TCM-HP) is the high generalization and summary for actions, both of which come from long-term effective clinical practice in two thousands of years in China. However, the specific relationship between TCM-HP and action of TCM is complex and unclear from a scientific perspective. The research about this is conducive to expound the connotation of TCM-HP theory and is of important significance for the development of the TCM-HP theory.MethodsOne hundred and thirty-three herbs including 88 heat-clearing herbs (HCHs) and 45 blood-activating stasis-resolving herbs (BAHRHs) were collected from reputable TCM literatures, and their corresponding TCM-HPs/actions information were collected from Chinese pharmacopoeia (2015 edition). The Kennard–Stone (K–S) algorithm was used to split 133 herbs into 100 calibration samples and 33 validation samples. Then, machine learning methods including supported vector machine (SVM), k-nearest neighbor (kNN) and deep learning methods including deep belief network (DBN), convolutional neutral network (CNN) were adopted to develop action classification models based on TCM-HP theory, respectively. In order to ensure robustness, these four classification methods were evaluated by using the method of tenfold cross validation and 20 external validation samples for prediction.ResultsAs results, 72.7–100% of 33 validation samples including 17 HCHs and 16 BASRHs were correctly predicted by these four types of methods. Both of the DBN and CNN methods gave out the best results and their sensitivity, specificity, precision, accuracy were all 100.00%. Especially, the predicted results of external validation set showed that the performance of deep learning methods (DBN, CNN) were better than traditional machine learning methods (kNN, SVM) in terms of their sensitivity, specificity, precision, accuracy. Moreover, the distribution patterns of TCM-HPs of HCHs and BASRHs were also analyzed to detect the featured TCM-HPs of these two types of herbs. The result showed that the featured TCM-HPs of HCHs were cold, bitter, liver and stomach meridians entered, while those of BASRHs were warm, bitter and pungent, liver meridian entered.ConclusionsThe performance on validation set and external validation set of deep learning methods (DBN, CNN) were better than machine learning models (kNN, SVM) in sensitivity, specificity, precision, accuracy when predicting the actions of heat-clearing and blood-activating stasis-resolving based on TCM-HP theory. The deep learning classification methods owned better generalization ability and accuracy when predicting the actions of heat-clearing and blood-activating stasis-resolving based on TCM-HP theory. Besides, the methods of deep learning would help us to improve our understanding about the relationship between herbal property and action, as well as to enrich and develop the theory of TCM-HP scientifically.