Practice Of Traditional Chinese Medicine Research Articles

Evidence-based Chinese medicine：theory and practice

The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine. The basic concept of evidence-based Chinese medicine: EBCM is an applied discipline, following the theory and methodology of evidence-based medicine, to collect, evaluate, produce, transform the evidence of effectiveness, safety and economy of TCM, to reveal the feature and regular pattern of TCM taking effect, and to guide the development of clinical guidelines, clinical pathways and health decisions. The effects and achievements of EBCM development: secondary studies mainly based on systematic review/Meta-analysis were extensively carried out; clinical efficacy studies mainly relying on randomized controlled trials grew rapidly; clinical safety evaluations based on real world study have been conducted; methodological researches mainly focused on study quality control deepened gradually; internationalization researches mainly on report specifications have got some breakthroughs; standardization researches based on treatment specification were strengthened gradually; the research team and talents with the characteristics of inter-disciplinary have been steadily increased. A number of high-quality research findings have been published at international well-known journals; the clinical efficacy and safety evidence of TCM has been increased; the level of clinical rational use of TCM has been improved; a large number of Chinese patent medicines with big market have been cultured. The future missions of EBCM mainly consist of four categories (scientific research, methodology and standard, platform construction and personnel training) with nine tasks. ①Carry out systematic reviews to systematically collect clinical trial reports of TCM and establish database of clinical evidence of TCM; ②Carry out evidence transformation research to lay the foundation for the development of clinical diagnosis and treatment guidelines, clinical pathways of TCM, and for the screening of basic drug list and medical insurance list, and for the policy-making relevant to TCM; ③Conduct researches to evaluate the advantages and effective regular patterns of TCM and form the evidence chain of TCM efficacy; ④Carry out researches for the safety evaluation of TCM, and provide evidence supporting the rational and safe use of TCM in clinical practice; ⑤Conduct researches on methodology of EBCM and provide method for developing high quality evidence; ⑥Carry out researches to develop standards and norms of TCM, and to form methods, standards, specifications and technical systems; ⑦Establish data management platform for evidence-based evaluation of TCM, and promote data sharing; ⑧Build international academic exchange platform to promote international cooperation and mutual recognition of EBCM research; ⑨Carry out education and popularization activities of evidence-based evaluation methods, and train undergraduate students, graduate students, clinical healthcare providers and practitioners of TCM. The development of EBCM, as it was, not only promoted the transformation of clinical research and decision-making mode of TCM, contributed to the modernization and internationalization of TCM, but also enriched the connotation of Evidence-based Medicine.

Adoption of Traditional Chinese Medicine in a Central Mediterranean Island Community

The Maltese Islands in the central Mediterranean was one of the earliest European countries to initiate political relationships with the People's Republic of China. The political interaction translated eventually to a better appreciation of the cultural diversity of the respective countries. This appreciation led to an early adoption of traditional Chinese medicine (TCM) services and their incorporation within the mainline western-based contemporary medicine generally practiced on the Islands. TCM clinical services were formally introduced in the public government-managed hospital in 1994 after a bilateral agreement was signed between the health ministries of the two respective countries. This service has now extended into the private health sector. The adoption of TCM clinical services, in the light of a greater acceptance of TCM by the patients, necessitated specific legislation to regulate the practice of TCM within the legal framework of the Maltese Healthcare Professions Act. In more recent years, since 2015, the University of Malta in collaboration with Shanghai University of TCM, have provided a postgraduate master program in TCM aimed at graduates holding a primary degree in a western-oriented health-care science.

Localised Communities and Mass Healing Practice: The Case of Guangxi, China

Healing, as a way of maintaining health in human beings, has been derived primarily from social and cultural concepts and events. This article investigates what may be termed as ‘mass healing practice’ and the way in which this form of healing has been passed down through generations in Guangxi’s local communities. It examines the environmental as well as social and cultural elements underlying the localised healthcare tradition and analyses how this form of mass healing practice continues to largely exist on its own in present day Guangxi. This article briefly compares mass healing practice with the practice of modern western medicine and traditional Chinese medicine in other social contexts, and presents the argument that mass healing practice and mass healing education developed in Guangxi’s isolated local communities are more elaborately rooted in the social and cultural matrix of such communities relative to the other forms of healthcare practice. This is because indigenous mass healing practices and education in isolated communities are not only related to people’s everyday life, but are also understood, in varying degrees, as community-wide social activities.

I19 Major achievements of traditional medicine in treating epidemic and chronic diseases

A long history of use and extensive documentation of the clinical practices of traditional Chinese medicine resulted in a considerable number of classical preparations, which are still widely used. This heritage of our ancestors provides a unique resource for drug discovery. Already, a number of important drugs have been developed from traditional medicines, which in fact form the core of Western pharmacotherapy. Therefore, this article discusses the differences in drug development between traditional medicine and Western medicine and uses discovery of artemisinin as an example that illustrates the “bedside–bench–bedside” approach to drug discovery to explain that the middle way for drug development is to take the advantage of the best features of these two distinct systems and compensate for certain weaknesses in each. This article also summarizes evidence-based traditional medicines and discusses quality control and quality assessment, the crucial steps in botanical drug development. Herbgenomics may provide effective tools to clarify their molecular mechanism in the botanical drug development. The totality-of-the-evidence approach used by the U.S. Food and Drug Administration for botanical products provides the directions on how to carry out quality control from the field throughout the entire production process.

Discussion on physiological of Human: construction and significance of the theory of ″Qi-Tube-Viscera″

This article briefly summarized the meaning, category and function of qi, tubes and viscera in human body respectively after combining exploring the theories of traditional Chinese medicine(TCM) and clinical practices. Afterward, we put forward the theory of Qi-Tube-Viscera and elaborated its close relationship with the physiological status of the human, and then we thought the relationships of qi, tube and viscera respectively, at last we draw a conclusion that qi, tube and viscera only came from qi. And the clinical guiding significance of the theory of Qi-Tube-Viscera and itsBalanced steady state, Nature and Man in One, State medicine were narrated to demonstrate that new theory of Qi-Tube-Viscera has high signifance in the theory of TCM and clinical practice. Key words: Qi; Tube; Viscera; Physiological

Treatment effects of the traditional Chinese medicine Shenks in bleomycin-induced lung fibrosis through regulation of TGF-beta/Smad3 signaling and oxidative stress

Pulmonary fibrosis is a kind of devastating interstitial lung disease due to the limited therapeutic strategies. Traditional Chinese medicine (TCM) practices have put forth Shenks as a promising treatment approach. Here, we performed in vivo study and in vitro study to delineate the anti-fibrotic mechanisms behind Shenks treatment for pulmonary fibrosis. We found that regardless of the prophylactic or therapeutic treatment, Shenks was able to attenuate BLM-induced-fibrosis in mice, down regulate extracellular matrix genes expression, and reduce collagen production. The aberrantly high Smad3 phosphorylation levels and SBE activity in TGF-β-induced fibroblasts were dramatically decreased as a result of Shenks treatment. At the same time, Shenks was able to increase the expression of antioxidant-related genes, including Gclc and Ec-sod, while reduce the transcription levels of oxidative-related genes, such as Rac1 and Nox4 demonstrated by both in vivo and in vitro studies. Further investigations found that Shenks could decrease the oxidative productions of protein (3-nitrotyrosine) and lipid (malondialdehyde) and increase GSH content both in bleomycin treated mouse lungs and TGF-β stimulated fibroblasts, as well as inhibit the production of ROS stimulated by TGF-β to fight against oxidative stress. Overall, Shenks inhibited fibrosis by blocking TGF-β pathway and modulating the oxidant/antioxidant balance.

Identification of anti-tumor components from toad venom.

Secretion of granular glands from the skin of amphibians is a fascinating resource of active substances, particularly for cancer therapy in clinical practice of Traditional Chinese Medicine. A variety of anti-tumor peptides have been isolated from different toads and frogs; however, no anti-tumor peptides are reported in toad venom of Bufo gargarizans. Firstly, soluble fraction from fresh toad venom (FTV) was compared with that from dried toad venom (DTV), using HPLC analysis. It was revealed that FTV has a different HPLC chromatography compared with DTV. Soluble fraction of FTV is more toxic to SH-SY5Y cells than that of DTV, as evaluated by MTT assay. Secondly, it was identified that protein components from soluble fractions of FTV and DTV possess different patterns by SDS-PAGE analysis, and proteins from FTV are also more toxic than that from DTV. Thirdly, an immobilized basic fibroblast growth factor (bFGF) affinity column was used to isolate bFGF-binding components from soluble fraction of FTV, and it was identified that bFGF-binding components prohibited bFGF-dependent neurite growth of SH-SY5Y cells. Finally, it was identified that bFGF-binding components activated apoptosis via upregulation of caspase-3 and caspase-8 expression in SH-SY5Y cells. These data suggest that FTV contains active components that interact with bFGF and activate apoptosis in SH-SY5Y cells.

Dietary capsaicin and its anti-obesity potency: from mechanism to clinical implications.

Obesity is a growing public health problem, which has now been considered as a pandemic non-communicable disease. However, the efficacy of several approaches for weight loss is limited and variable. Thus, alternative anti-obesity treatments are urgently warranted, which should be effective, safe, and widely available. Active compounds isolated from herbs are similar with the practice of Traditional Chinese Medicine, which has a holistic approach that can target to several organs and tissues in the whole body. Capsaicin, a major active compound from chili peppers, has been clearly demonstrated for its numerous beneficial roles in health. In this review, we will focus on the less highlighted aspect, in particular how dietary chili peppers and capsaicin consumption reduce body weight and its potential mechanisms of its anti-obesity effects. With the widespread pandemic of overweight and obesity, the development of more strategies for the treatment of obesity is urgent. Therefore, a better understanding of the role and mechanism of dietary capsaicin consumption and metabolic health can provide critical implications for the early prevention and treatment of obesity.

Chemical Comparison of Two Drying Methods of Mountain Cultivated Ginseng by UPLC-QTOF-MS/MS and Multivariate Statistical Analysis

In traditional Chinese medicine practice, drying method is an essential factor to influence the components of Chinese medicinal herbs. In this study, an ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC-QTOF-MS/MS)-based approach was used to compare the content of chemical compounds of mountain cultivated ginseng that had been natural air dried (LX-P) and vacuum freeze-dried (LX-L). Multivariate statistical analysis such as principal component analysis (PCA) and supervised orthogonal partial least squared discrimination analysis (OPLS-DA) were used to select the influential components of different samples. There were 41 ginsenosides unambiguously identified and tentatively assigned in both LX-L and LX-P. The results showed that the characteristic components in LX-P were ginsenoside Rb1, ginsenoside Rc, ginsenoside Rg6, dendrolasin, and ginsenoside Rb2. The characteristic components in LX-L were malonyl-ginsenoside Re, malonyl-ginsenoside Rb1, malonyl-ginsenoside Rc, malonyl-ginsenoside Rb1 isomer, malonyl-ginsenoside Rb2, malonyl-ginsenoside Rb3, malonyl-ginsenoside Rd isomer, gypenoside XVII, and notoginsenoside Fe. This is the first time that the differences between LX-L and LX-P have been observed systematically at the chemistry level. It was indicated that vacuum freeze-drying method can improve the content of malonyl-ginsensides in mountain cultivated ginseng.

A Network-Based Pharmacology Study of the Herb-Induced Liver Injury Potential of Traditional Hepatoprotective Chinese Herbal Medicines.

Herbal medicines are widely used for treating liver diseases and generally regarded as safe due to their extensive use in Traditional Chinese Medicine practice for thousands of years. However, in recent years, there have been increased concerns regarding the long-term risk of Herb-Induced Liver Injury (HILI) in patients with liver dysfunction. Herein, two representative Chinese herbal medicines: one—Xiao-Chai-Hu-Tang (XCHT)—a composite formula, and the other—Radix Polygoni Multiflori (Heshouwu)—a single herb, were analyzed by network pharmacology study. Based on the network pharmacology framework, we exploited the potential HILI effects of XCHT and Heshouwu by predicting the molecular mechanisms of HILI and identified the potential hepatotoxic ingredients in XCHT and Heshouwu. According to our network results, kaempferol and thymol in XCHT and rhein in Heshouwu exhibit the largest number of liver injury target connections, whereby CASP3, PPARG and MCL1 may be potential liver injury targets for these herbal medicines. This network pharmacology assay might serve as a useful tool to explore the underlying molecular mechanism of HILI. Based on the theoretical predictions, further experimental verification should be performed to validate the accuracy of the predicted interactions between herbal ingredients and protein targets in the future.

Effect of Folate Status on High‐Fat Diet‐Induced Obese Mice with Chronic Aristolochic Acid Nephropathy

A negative correlation has been reported between human serum folate levels and chronic kidney failure. Reducing folate intake in modern diets high in fat/calories along with low vegetables/fruits might be associated with increased risk for kidney disease in industrialized countries without folic acid fortification policy. To investigate whether folate status affects renal function in high‐fat diet‐induced obesity, four groups of C57BL/6 male mice were either fed normal‐fat diet with folate (NF‐f1) as negative control, or high‐fat diet without folate (HF‐f0), with folate (HF‐f1), with 10‐fold folate (HF‐f10). After 48 weeks' feeding, the HF groups obese mice were supplemented with 8 mg/Kg/day aristolochic acid (AA), a nitrophenanthrene carboxylic acid found in Aristolochic species used in the practice of traditional Chinese medicine, for 3 weeks to induce AA nephropathy (AAN) before sacrifice. The results showed that urine protein of mice fed AA‐containing diets, except the HF‐f10 group, significantly increased. Serum and renal galactin‐3, renal IL‐6 and TNF‐a in obese mice with chronic AAN were significantly higher when compared to the NF‐f1 mice without AA induction. The HF‐f10 mice had lower serum creatinine and higher IL‐10 secretion from ConA‐stimulated splenocytes. In contrast, the HF‐f0 mice had significantly higher urine protein, serum galaction‐3 and IL‐6, renal TGF‐b, and IL‐2 and TGF‐b secretion from splenocytes. Serum folate levels were negatively correlated with renal IL‐6, IL‐1b, TNF‐a, and IL‐10 in the HF‐f0 mice. Our study suggested that folate deficiency might promote, but folate supplementation might protect from renal inflammation and fibrosis progression in high‐fat diet‐induced obese mice.Support or Funding InformationFunded by the Ministry of Science and Technology Science Council of the Republic of China [MOST105‐2320‐B‐002‐028‐MY3]

Macroscopic authentication of Chinese materia medica (CMM): A UK market study of seeds and fruits

This small-scale macroscopic and quantitative authentication study, the first of its kind in the UK and elsewhere, assesses the identity and purity (excluding pesticides and heavy metals) of a selection of Chinese materia medica (CMM) seeds and fruits on the UK market. 25 fruit and seed CMM were chosen based on their inclusion in the Chinese Pharmacopoeia (2010, referred hereafter as ‘official species’), maximum dimension of 10mm, and regular use in Traditional Chinese Medicine (TCM) practice in the UK according to UK practitioners. In 2012 samples were obtained from six TCM wholesale traders and eight retail dispensaries in southeast England. Macroscopic identity and purity testing was undertaken drawing on expertise at the Royal Botanic Gardens, Kew and its collection of vouchered CMM reference drugs, herbarium specimens and published identification texts. Of the 25 CMM requested from suppliers, 23 were obtained, represented by 211 samples. 191 samples were identified as being sourced from the correct drug; 20 were identified as sourced from unofficial species. Of the 191 correct samples, 5 displayed major contamination by other plant material, stones, earth, etc. (defined as >5% of sample volume), and 12 had minor contamination (2–5%). 95% of samples derived from medicinally cultivated plants were sourced from an official species, 5% were contaminated; in contrast, 78% of wild-sourced CMM samples were sourced from an official species, and 14% showed contamination. These results aim to guide the further development of good practice in TCM herbal drug quality control, for which suggestions are provided.

Healthcare needs and access in a sample of Chinese young adults in Vancouver, British Columbia: A qualitative analysis

ObjectivesImmigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The purpose of this study was to examine the health beliefs, health behaviors, primary care access, and perceived unmet healthcare needs of Chinese young adults. MethodsSemi-structured in-depth interviews were carried out with eight Chinese young adults in Vancouver, Canada. ResultsA content analysis revealed that these Chinese young adults experienced unmet healthcare needs, did not have a primary care provider, and did not access preventive services. Cultural factors such as strong family ties, filial piety, and the practice of Traditional Chinese Medicine influenced their health behaviors and healthcare access patterns. ConclusionChinese young adults share similar issues with other young adults in relation to not having a primary care provider and accessing preventive care but their health beliefs and practices make their needs for care unique from other young adults.

Development, Status and Opportunities of Acupuncture in Qatar

This paper presents an outline of the current status, regulations, and qualifications required for the practice of traditional Chinese medicine (TCM) and acupuncture in Qatar. The paper also provides an overview of the challenges and opportunities that face practitioners of Acupuncture as a complimentary medicine in Qatar and the recent licensing mechanisms introduced in January 2016. Qatar's 2030 vision and demand for continued development and sustainable growth includes the Chinese initiative ‘One Belt, One Road’ project which offers a golden opportunity for the further development of TCM in Qatar. The findings of this paper suggest that there are now real possibilities China and Qatar to cooperate in the exchange of medical services, training and education in the field of TCM.

Nonpharmacological interventions to improve quality of life in heart failure: an integrative review.

to identify articles that assessed the effectiveness or efficacy of nonpharmacological interventions to improve quality of life of people with heart failure in the literature. an integrative literature review was performed in Lilacs, MedLine and SciELO databases, including randomized or nonrandomized clinical trials and quasi-experimental studies published between 2003 and 2014, in Portuguese, English or Spanish. twenty-three studies were included. The categories of nonpharmacological interventions that improved quality of life of people with heart failure were: Remote health monitoring, Instructions on health practices, Physical activity follow-up and Traditional Chinese Medicine practices. these results can guide the selection of interventions to be implemented by health professionals that treat people with heart failure. Future systematic reviews with meta-analyses are needed in order to identify the most effective interventions for improving these individuals' quality of life.

Transcriptome Analysis of Secondary Metabolism Pathway, Transcription Factors, and Transporters in Response to Methyl Jasmonate in Lycoris aurea.

Lycoris aurea, a medicinal species of the Amaryllidaceae family, is used in the practice of traditional Chinese medicine (TCM) because of its broad pharmacological activities of Amaryllidaceae alkaloids. Despite the officinal and economic importance of Lycoris species, the secondary mechanism for this species is relatively deficient. In this study, we attempted to characterize the transcriptome profiling of L. aurea seedlings with the methyl jasmonate (MeJA) treatment to uncover the molecular mechanisms regulating plant secondary metabolite pathway. By using short reads sequencing technology (Illumina), two sequencing cDNA libraries prepared from control (Con) and 100 μM MeJA-treated (MJ100) samples were sequenced. A total of 26,809,842 and 25,874,478 clean reads in the Con and MJ100 libraries, respectively, were obtained and assembled into 59,643 unigenes. Among them, 41,585 (69.72%) unigenes were annotated by basic local alignment search tool similarity searches against public sequence databases. These included 55 Gene Ontology (GO) terms, 128 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and 25 Clusters of Orthologous Groups (COG) families. Additionally, 4,175 differentially expressed genes (DEGs; false discovery rate ≤ 0.001 and |log2 Ratio| ≥ 1) with 2,291 up-regulated and 1,884 down-regulated, were found to be affected significantly under MeJA treatment. Subsequently, the DEGs encoding key enzymes involving in the secondary metabolite biosynthetic pathways, transcription factors, and transporter proteins were also analyzed and summarized. Meanwhile, we confirmed the altered expression levels of the unigenes that encode transporters and transcription factors using quantitative real-time PCR (qRT-PCR). With this transcriptome sequencing, future genetic and genomics studies related to the molecular mechanisms associated with the chemical composition of L. aurea may be improved. Additionally, the genes involved in the enrichment of secondary metabolite biosynthesis-related pathways could enhance the potential applications of L. aurea.

Anti-Aging Implications of Astragalus Membranaceus (Huangqi): A Well-Known Chinese Tonic.

Owing to a dramatic increase in average life expectancy and the Family Planning program of the 1970s - 1990s, China is rapidly becoming an aging society. Therefore, the investigation of healthspan-extending drugs becomes more urgent. Astragalus membranaceus (Huangqi) is a major medicinal herb that has been commonly used in many herbal formulations in the practice of traditional Chinese medicine (TCM) to treat a wide variety of diseases and body disorders, or marketed as life-prolonging extracts for human use in China, for more than 2000 years. The major components of Astragalus membranaceus are polysaccharides, flavonoids, and saponins. Pharmacological research indicates that the extract component of Astragalus membranaceus can increase telomerase activity, and has antioxidant, anti-inflammatory, immunoregulatory, anticancer, hypolipidemic, antihyperglycemic, hepatoprotective, expectorant, and diuretic effects. A proprietary extract of the dried root of Astragalus membranaceus, called TA-65, was associated with a significant age-reversal effect in the immune system. Our review focuses on the function and the underlying mechanisms of Astragalus membranaceus in lifespan extension, anti-vascular aging, anti-brain aging, and anti-cancer effects, based on experimental and clinical studies.

Theoretical basis, application, reliability, and sample size estimates of a Meridian Energy Analysis Device for Traditional Chinese Medicine Research

OBJECTIVES:The Meridian Energy Analysis Device is currently a popular tool in the scientific research of meridian electrophysiology. In this field, it is generally believed that measuring the electrical conductivity of meridians provides information about the balance of bioenergy or Qi-blood in the body.METHODS AND RESULTS: PubMed database based on some original articles from 1956 to 2014 and the authoŕs clinical experience. In this short communication, we provide clinical examples of Meridian Energy Analysis Device application, especially in the field of traditional Chinese medicine, discuss the reliability of the measurements, and put the values obtained into context by considering items of considerable variability and by estimating sample size.CONCLUSION:The Meridian Energy Analysis Device is making a valuable contribution to the diagnosis of Qi-blood dysfunction. It can be assessed from short-term and long-term meridian bioenergy recordings. It is one of the few methods that allow outpatient traditional Chinese medicine diagnosis, monitoring the progress, therapeutic effect and evaluation of patient prognosis. The holistic approaches underlying the practice of traditional Chinese medicine and new trends in modern medicine toward the use of objective instruments require in-depth knowledge of the mechanisms of meridian energy, and the Meridian Energy Analysis Device can feasibly be used for understanding and interpreting traditional Chinese medicine theory, especially in view of its expansion in Western countries.

Antiinflammatory and Hepatoprotective Medicinal Herbs as Potential Substitutes for Bear Bile.

Practitioners of traditional Chinese medicine (TCM) commonly prescribe medicinal formulations relying on the purported synergism of a combination of plant species, sometimes incorporating animal parts and minerals. Bear bile, obtained from either wild or farmed bears, is a commonly used constituent of traditional medicine formulations. With several bear species now listed under Convention on International Trade in Endangered Species of Wild Fauna and Flora as threatened with extinction and with bear farming being actively campaigned against on ethical grounds, it is important to seek and promote alternatives to the use of bear bile as medicine. This chapter describes and evaluates the scientific data relating to the efficacy of bear bile and potential alternatives to its use, including the use of bile from other animal species, the use of synthetic chemical alternatives, and the use of herbal substitutes. Scientific studies have confirmed the efficacy of bear bile as an antiinflammatory and a hepatoprotective agent. Ursodeoxycholic acid (UDCA), the active component of bear bile is used in a synthetic form in Western medicine and can serve as an alternative to bear bile in the treatment and management of certain cholestatic liver conditions. In TCM practice, bile from domesticated animal species (such as cattle, chicken, and pig) has been used as a substitute for bear bile. Following evaluation of TCM literature and pharmacological/clinical data, the authors propose six plant species, either as single herbs or in combination, Gardenia jasminoides (zhī zi; ), Scutellaria baicalensis (huáng qín; ), Coptis chinensis (huáng lián, ), Phellodendron amurense (huáng băi; ), Andrographis paniculata (chuan xin lian; ), and Rheum palmatum (dà huang; ), two medicinal Kampo formulations, Orengedokuto, Dia-Orengedokuto (which originated from traditional Chinese herbal formula Huanglian Jiedu Tang, ), and two individual phytochemicals (berberine and andrographolide) as alternatives to bear bile. The proposed herbal alternatives are frequently found listed in traditional formulations also containing bear bile, usually with different therapeutic roles ascribed to them. The existing evidence base for the effectiveness of herbal alternatives is sufficiently strong for TCM practitioners and consumers to consider using these without the addition of bear bile. This consideration is driven by the imperative to protect populations of bears from overexploitation in the wild and when farmed. However, for the identified alternatives to be accepted by users, it is essential that researchers and TCM practitioners collaborate effectively to initiate consumer behavior change.

Integrating Traditional Chinese Medicine (TCM) practices into T2 diabetes mellitus treatment: incentives and challenges

Integrating Traditional Chinese Medicine (TCM) practices into T2 diabetes mellitus treatment: incentives and challenges