Traditional Chinese Medicine Research Research Articles

Establishment of XRD fourier fingerprint identification method of realgar decoction pieces and its anti-tumor activity in tumor-in-situ transplanted mice

Ethnopharmacological relevanceRealgar, a traditional mineral Chinese medicine, has been used in China for more than 2000 years. It has been recorded in many ancient and modern works that it has anti-cancer and anti-tumor effects. Of course, colon cancer is also within the scope of its treatment. Realgar needs to be processed into realgar decoction pieces by water grinding before being used for medicine. To ensure the consistency of efficacy and quality of realgar decoction pieces, modern methods need to be used for further quality control. Aim of the studyThe research of traditional mineral Chinese medicine is relatively difficult, and the related research is less. The purpose of this study is to control the quality of realgar decoction pieces by modern analytical technology and analyze its components. On this basis, its anti-colon cancer activity was discussed. Materials and methodsSeveral batches of realgar decoction pieces were analyzed by XRD, and the components of realgar decoction pieces were obtained. The quality control fingerprints of realgar decoction pieces were established by processing XRD spectra and similarity evaluation. Then, the effects of realgar decoction pieces on apoptosis of CT26 and HTC-116 cells were observed in vitro by Hoechst 33258 staining, flow cytometry, measurement of mitochondrial membrane potential and Western blot; In vivo, the mouse model of tumor-in-situ transplantation of colon cancer was established, and the related indexes were observed. ResultThe explorations showed that the XRD Fourier fingerprints of realgar decoction pieces samples that had the same phase revealed 10 common peaks, respectively. The similarity evaluation of the established XRD Fourier fingerprint was greater than 0.900. We also demonstrated that realgar decoction pieces can promote apoptosis and inhibit tumor growth in colon cancer cells, its activating effect on p53 protein, and its safety when used within reasonable limits. ConclusionThe quality control of realgar decoction pieces by XRD is scientific and has the inhibitory effect on colon cancer, which has the development potential.

Chinese text recognition and knowledge graph of Shen Nong Ben Cao Jing based on BERT pre-trained language models

Background: The research and utilization of ancient traditional Chinese medicine (TCM) books are relatively limited at present. With the rapid development of artificial intelligence (AI), knowledge graph related technology has brought light on this field. Objective: To construct the knowledge graph of Shen Nong Ben Cao Jing, analyze basic knowledge of materia medica, explore implicit knowledge, and conduct visualization display, as well to provide methodological references for the study of ancient TCM books. Methods: The types of knowledge entities and relationships between entities in Shen Nong Ben Cao Jing were analyzed. A training corpus dataset was produced by using the BIO sequence labeling method; a self-developed CNLP text labeling system was used for text labeling; the BERT model was used to recognize named entities; the relationships between entities were set based on rules and semantic associations; the data into the Neo4j-community 4.4.9 graph database was imported by using Cypher language for storage and visualization display after knowledge fusion; finally, a knowledge graph was constructed. Results: The knowledge graph of Shen Nong Ben Cao Jing included 5, 273 nodes and 11, 064 relationships. The schema layer contained 14 entity types and 15 relationship types. Through the query, knowledge can be visualized from the aspects of classification, property, and seven mutual relationships of herbal combination. Conclusion: The knowledge graph constructed in this study directly reflects the knowledge recorded in Shen Nong Ben Cao Jing and the relationship between them, which is suitable for knowledge mining and intuitive multi-dimensional display of ancient TCM books.

Bibliometric analysis of traditional Chinese medicine in the treatment of inflammatory bowel disease

Objective: This study conducts a bibliometric analysis of literature on the treatment of inflammatory bowel disease (IBD) with traditional Chinese medicine (TCM) to explore its research status, hotspots, and development trends, providing ideas and references for further research. Method: We screened literature for treating IBD with TCM from the Web of Science Core Collection (WOSCC), and used the VOSviewer software (1.6.18) to discover cooperation among countries, institutions, authors, and information on journals, keywords, etc. We use the CiteSpace software (6.2.R2) to analyze co-citation and burst discovery of references. Results: In all, 440 relevant literature papers were searched and screened from the WOSCC database. The results showed that the number of publications concerning treating IBD with TCM has shown a significant growth in the past decade. China is far ahead in terms of article output, occupying a dominant position. The institution with the most published articles is Nanjing University of Traditional Chinese Medicine. The authors who have published most of the articles are Dai Yancheng, Shi Rui, and Zhou Lian. The Journal of Ethnopharmacology published maximum articles in this field, while Gastroenterology was the most cited journal. Ungaro et al.’s article entitled “Ulcerative colitis” (https://doi.org/10.1016/S0140-6736(16)32126-2), published in The Lancet in 2017 was the most cited study. The high-frequency keywords mainly include ulcerative colitis, inflammation, NF-κB, expression, traditional Chinese medicine, gut microbiota, activation, mice, cells, etc. Conclusions: The research heat for treating IBD with TCM has risen over the past decade, with studies focusing on three main aspects: clinical studies of TCM, basic pharmacology, and animal experimental research. The research hotspot shifted from pathogenesis, clinical study of TCM, basic pharmacology, and complementary therapies to the study of network pharmacology and the mechanism of action of TCM related to gut microbiota. Network pharmacology and gut microbiota are at the frontiers of research and turning to be the future research trends to provide new insights and ideas for further research for treating IBD with TCM.

Small RNA sequencing highlights a potential regulatory network mediated by Gecko miRNA affecting the prognosis of hepatocellular carcinoma.

Gecko has been widely documented in Chinese scientific literature as an anti-tumor agent for various illnesses for thousands of years, and more recently, it has been examined for its anti-tumor effects on several cancers. The effect of Gecko microRNAs (miRNAs) on hepatocellular carcinoma (HCC) has not yet been reported. This study was designed to identify miRNAs in Gecko through small RNA sequencing and utilize bioinformatics techniques to construct a potential regulatory network and explore the possible mechanisms of exogenous miRNAs involved in HCC. RNA was extracted from Gecko tablets, and we screened the Gecko miRNA expression dataset after high-throughput sequencing. Bioinformatics analysis was used to identify novel Gecko and HCC survival-related miRNA-mRNA cross-species regulation networks. miR-100-5p, miR-99a-5p and miR-101-3p were identified as critical for the role of Geckos in HCC. Nine downstream mRNAs (EZH2, KPNA2, LMNB1, LRRC1, MRGBP, SMARCD1, STMN1, SUB1, and UBE2A) were identified as target genes for critical miRNAs. A miRNA-mRNA regulatory network was constructed, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed these key mRNAs might be associated with both the suppression and progression of HCC. The novel network significantly correlated with the abundance of multiple immune cells, as determined with immune infiltration analysis. These findings suggest that Gecko may inhibit progression and exert a therapeutic effect on HCC by targeting critical miRNA-mRNA networks for cross-species regulation. It also provides a reference for future research and development of traditional Chinese medicine (TCM).

Based on the Molecular Mechanism of CiteSpace Sanqi Total Saponin and the Prevention and Treatment of Renal Fibrosis, Hot Spot Visualization Analysis

This study aims to study the current situation, hot spots and development trends of Sanqi total saponins in the prevention and treatment of renal fibrosis through a visual map, in order to provide a direction and trend for the research of traditional Chinese medicine on the prevention and treatment of renal fibrosis. Method: By using CiteSpace visualization software, the relevant literature on the use of Sanqi total saponins in the CNKI database for the treatment of renal fibrosis was visually analyzed, including posting trends, authors, institutions and keywords, and the corresponding knowledge map was generated. Results: From 2005 to 2022, a total of 1,533 documents were included in the research results. From 2008 to 2017, an average of 99 articles were published every year, accounting for 67.5% of the total number of articles published. Among them, the number of articles published in 2010 and 2013 reached 114, the highest in previous years. At the same time, Yang Min is the author who has published the most articles, with a total of 29 papers. Beijing University of Traditional Chinese Medicine is the main research institution in this field. Through cluster analysis of research hotspots, ten clusters were obtained, including rats, left ventricular reconstruction, oxidative stress, drug interaction, astragaloside, apoptosis, matrix metalloproteinase-9,oleoside, lipopolysaccharide, atherosclerosis, etc. Future research focuses include oxidative stress, autophagy process, Sanqi total saponins, inflammatory response, cell proliferation and apoptosis, and pharmacokinetics. Conclusion: The knowledge map reveals the research status and research hotspots of Sanqi total saponins in the prevention and treatment of renal fibrosis, including oxidative stress, inflammation, cell proliferation and apoptosis, which will become the focus of research on the prevention and treatment of renal fibrosis in traditional Chinese medicine in the future. However, the collaboration between research authors and scientific research institutions lacks closeness, lacks core authors, and has not yet formed an influential research organization. The depth and breadth of research need to be further enhanced.

The complete Chloroplast genome of Stachys geobombycis and comparative analysis with related Stachys species

Herb genomics, at the forefront of traditional Chinese medicine research, combines genomics with traditional practices, facilitating the scientific validation of ancient remedies. This integration enhances public understanding of traditional Chinese medicine’s efficacy and broadens its scope in modern healthcare. Stachys species encompass annual or perennial herbs or small shrubs, exhibiting simple petiolate or sessile leaves. Despite their wide-ranging applications across various fields, molecular data have been lacking, hindering the precise identification and taxonomic elucidation of Stachys species. To address this gap, we assembled the complete chloroplast (CP) genome of Stachys geobombycis and conducted reannotation and comparative analysis of seven additional species within the Stachys genus. The findings demonstrate that the CP genomes of these species exhibit quadripartite structures, with lengths ranging from 14,523 to 150,599 bp. Overall, the genome structure remains relatively conserved, hosting 131 annotated genes, including 87 protein coding genes, 36 tRNA genes, and 8 rRNA genes. Additionally, 78 to 98 SSRs and long repeat sequences were detected , and notably, 6 highly variable regions were identified as potential molecular markers in the CP genome through sequence alignment. Phylogenetic analysis based on Bayesian inference and maximum likelihood methods strongly supported the phylogenetic position of the genus Stachys as a member of Stachydeae tribe. Overall, this comprehensive bioinformatics study of Stachys CP genomes lays the groundwork for phylogenetic classification, plant identification, genetic engineering, evolutionary studies, and breeding research concerning medicinal plants within the Stachys genus.

Acupuncture and tuina knowledge graph with prompt learning.

Acupuncture and tuina, acknowledged as ancient and highly efficacious therapeutic modalities within the domain of Traditional Chinese Medicine (TCM), have provided pragmatic treatment pathways for numerous patients. To address the problems of ambiguity in the concept of Traditional Chinese Medicine (TCM) acupuncture and tuina treatment protocols, the lack of accurate quantitative assessment of treatment protocols, and the diversity of TCM systems, we have established a map-filling technique for modern literature to achieve personalized medical recommendations. (1) Extensive acupuncture and tuina data were collected, analyzed, and processed to establish a concise TCM domain knowledge base. (2)A template-free Chinese text NER joint training method (TemplateFC) was proposed, which enhances the EntLM model with BiLSTM and CRF layers. Appropriate rules were set for ERE. (3) A comprehensive knowledge graph comprising 10,346 entities and 40,919 relationships was constructed based on modern literature. A robust TCM KG with a wide range of entities and relationships was created. The template-free joint training approach significantly improved NER accuracy, especially in Chinese text, addressing issues related to entity identification and tokenization differences. The KG provided valuable insights into acupuncture and tuina, facilitating efficient information retrieval and personalized treatment recommendations. The integration of KGs in TCM research is essential for advancing diagnostics and interventions. Challenges in NER and ERE were effectively tackled using hybrid approaches and innovative techniques. The comprehensive TCM KG our built contributes to bridging the gap in TCM knowledge and serves as a valuable resource for specialists and non-specialists alike.

Traditional Chinese Medicine Knowledge Graph Construction Based on Large Language Models

This study explores the use of large language models in constructing a knowledge graph for Traditional Chinese Medicine (TCM) to improve the representation, storage, and application of TCM knowledge. The knowledge graph, based on a graph structure, effectively organizes entities, attributes, and relationships within the TCM domain. By leveraging large language models, we collected and embedded substantial TCM–related data, generating precise representations transformed into a knowledge graph format. Experimental evaluations confirmed the accuracy and effectiveness of the constructed graph, extracting various entities and their relationships, providing a solid foundation for TCM learning, research, and application. The knowledge graph has significant potential in TCM, aiding in teaching, disease diagnosis, treatment decisions, and contributing to TCM modernization. In conclusion, this paper utilizes large language models to construct a knowledge graph for TCM, offering a vital foundation for knowledge representation and application in the field, with potential for future expansion and refinement.

Study on the mechanism of Cutaneous and Respiratory Comorbidities with Chinese and Western medicine theories and research

AbstractIn the realms of traditional Chinese medicine and Western medicine research, the skin and lungs are recognized for their integral roles in both the physiological functions and pathological mechanisms affecting the human body. These organs are not only complementary and coordinated in their physiological functions but also interact pathologically, providing feedback and influencing each other. The etiology of immune‐mediated skin diseases is multifaceted, involving numerous factors beyond mere skin characteristics, often including multisystem diseases. Cutaneous and Respiratory Comorbidities denote the concurrent presence of skin and lung diseases, sharing a common pathogenic mechanism. Although research on Cutaneous and Respiratory Comorbidities has received increasing attention, the foundational theories and the specifics of related diseases remain unclear. This paper aims to elucidate the theoretical basis of both traditional Chinese and Western medicine concerning immune‐mediated Cutaneous and Respiratory Comorbidities, thereby laying a groundwork for the early detection and integrated treatment of these diseases.

Molecular mechanisms underlying the therapeutic effects of Linggui Zhugan decoction in stroke: Insights from network pharmacology and single-cell transcriptomics analysis.

Linggui Zhugan decoction (LZD), a traditional Chinese medicine formula, has demonstrated significant therapeutic effects in managing poststroke cognitive impairment and hemiplegia. However, the precise molecular mechanisms underlying its efficacy remain incompletely elucidated. The active ingredients and target proteins of LZD were retrieved from the traditional Chinese medicine systems pharmacology database and analysis platform database, which is specifically designed for traditional Chinese medicine research. The stroke-related genes were obtained from publicly available databases. Protein-protein interaction, enrichment analysis, and single-cell data analysis were conducted to identify key cells, targets, and pathways. Molecular docking was employed to assess the binding affinity between key components and targets. Network pharmacology analysis identified 190 active ingredients and 248 targets in LZD. These targets were significantly enriched in processes and pathways such as cellular response to lipid, orexin receptor pathway, and were significantly associated with Cerebral infarction and Middle Cerebral Artery Occlusion. Intersection analysis with 2035 stroke-related genes revealed 144 potential targets, which exhibited 2870 interactions and were significantly enriched in signaling pathways such as PI3K-AKT single pathway, MAPK single pathway, and tumor necrosis factor single pathway. Gene set variation analysis showed that the targets of LZD exhibited higher enrichment scores in microglia, M2 macrophages, endothelial cells, and neutrophils, while lower enrichment scores were observed in oligodendrocytes. Furthermore, molecular docking demonstrated a strong binding affinity between key active ingredients and targets. Network pharmacology and single-cell sequencing analysis elucidated the key cells, pathways, targets, and components involved in the therapeutic mechanism of LZD for the treatment of stroke.

Research Progress in Understanding the Molecular Biology of Cordyceps militaris

Cordyceps militaris (C. militaris) is a valued medicinal fungus that can be traced back thousands of years in traditional Chinese medicine (TCM). Both TCM and modern scientific research have confirmed the positive effects of C. militaris on human health. In recent years, C. militaris has gained wide popularity; unfortunately, strains often degrade during cultivation, resulting in a decline in fruiting bodies and active components that negatively impacts the development of C. militaris in the health food and medicine industries. This review summarizes the current progresses in research on the genomic, transcriptomic, proteomic, and genetic manipulation of C. militaris and discusses its primary metabolites and strain degradation mechanisms. The current challenges and future prospects of C. militaris research are also discussed.

MedChatZH: A tuning LLM for traditional Chinese medicine consultations

Generative Large Language Models (LLMs) have achieved significant success in various natural language processing tasks, including Question-Answering (QA) and dialogue systems. However, most models are trained on English data and lack strong generalization in providing answers in Chinese. This limitation is especially evident in specialized domains like traditional Chinese medical QA, where performance suffers due to the absence of fine-tuning and high-quality datasets. To address this, we introduce MedChatZH, a dialogue model optimized for Chinese medical QA based on transformer decoder with LLaMA architecture. Continued pre-training on a curated corpus of Chinese medical books is followed by fine-tuning with a carefully selected medical instruction dataset, resulting in MedChatZH outperforming several Chinese dialogue baselines on a real-world medical dialogue dataset. Our model, code, and dataset are publicly available on GitHub (https://github.com/tyang816/MedChatZH) to encourage further research in traditional Chinese medicine and LLMs.

The Application of Artificial Intelligence in the Research and Development of Traditional Chinese Medicine

Review The Application of Artificial Intelligence in the Research and Development of Traditional Chinese Medicine Zhipeng Ke 1,2, Minxuan Liu 1,2,3, Jing Liu 1,2, Zhenzhen Su 1,2, Lu Li 1,2, Mengyu Qian 1,2, Xinzhuang Zhang 1,2, Tuanjie Wang 1,2, Liang Cao 1,2, Zhenzhong Wang 1,2, and Wei Xiao 1,2, * 1 National Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture, Lianyungang 222106, China 2 Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang 222104, China 3 ‍School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210009, China * Correspondence: xw_kanion@163.com Received: 4 September 2023 Accepted: 4 November 2023 Published: 6 March 2024 Abstract: With the accumulation of data in the pharmaceutical industry and the development of artificial intelligence technology, various artificial intelligence methods have been successfully employed in the drug discovery process. The integration of artificial intelligence in Traditional Chinese medicine has also gained momentum, encompassing quality control of Chinese patent medicines, prescriptions optimization, discovery of effective substances, and prediction of side effects. However, artificial intelligence also faces challenges and limitations in Traditional Chinese medicine development, such as data scarcity and complexity, lack of interdisciplinary professionals, black-box models, etc. Therefore, more research and collaboration are needed to address these issues and explore the best ways to integrate artificial intelligence and Traditional Chinese medicine to improve human health.

Guiding modern traditional Chinese medicine research using the theory of state‐target differentiation and treatment—Maintaining the validity of traditional Chinese medicine and creating new medical science

AbstractAs an important part of Chinese civilization, traditional Chinese medicine (TCM) has a long history and broad social foundation. In the development of modern medicine, TCM bears the responsibility of inheriting Chinese culture, while integrating with modern science and technology to continuously promote medical progress. The theory of “state‐target differentiation and treatment” is an innovative model combining Chinese and Western medicine that has provided a new mindset and method for modernizing TCM. This theory not only guides the reconstruction of modern TCM diagnosis and treatment systems, but also strongly promotes the reconstruction of the modern herbal system. As an emerging bioinformatics technology, phenomics research can reveal biological processes dynamically and quantitatively, which will help “open the black box” of TCM by providing technical methods to reveal the nature of “state” and the mechanism of “state modulation” in TCM. TCM can provide a valuable clinical reference from the perspective of disease cognition, sort out phenomics information parameters systematically and uniformly, and provide more accurate and meaningful data for phenomics research. The in‐depth combination of TCM and phenomics from the concept and technology will vigorously promote the development of human precision medicine. Modern TCM research guided by the theory of state‐target differentiation and treatment can effectively improve the scientific basis and targetability of clinical treatments and can also initiate a breakthrough in the integration of Chinese and Western medicine, further promoting the profound communication and cooperation between Chinese and Western medicine, so as to achieve better development of medicine in the future.

Guidelines for application of high-content screening in traditional Chinese medicine: concept, equipment, and troubleshooting

High-content screening (HCS) technology combines automated high-speed imaging hardware and single-cell quantitative analysis. It can greatly accelerate data acquisition in cellular fluorescence imaging and is a powerful research technique in traditional Chinese medicine (TCM). An increasing number of laboratories and platforms, including TCM laboratories, have begun utilizing HCS systems. However, this technology is still in its infancy in TCM research and there is a lack of sufficient experience with the associated concepts, instrument configurations, and analysis methods. To improve the understanding of HCS among researchers in the field of TCM, this paper summarizes the concept of HCS, software and hardware configuration, the overall research process, as well as common problems and related solutions of HCS in TCM research based on our team’s previous research experience, providing several research examples and an outlook on future perspectives, aiming to provide a technical guide for HCS in TCM research.

Development and testing of a post competency scale for traditional Chinese medicine physicians undergoing standardized training

ObjectiveTo develop and test a post competency scale for traditional Chinese medicine (TCM) physicians undergoing standardized training to provide an applicable tool for scientific evaluation. MethodsBased on literature analysis, behavioral event interviews, and expert consultations, measurement questions were formulated and the initial scale was designed. A questionnaire survey was conducted from July 2022 to May 2023 among TCM physicians undergoing standardized training in China. The rationality of the scale was confirmed through item purification, factor analysis, and tests of reliability and validity. ResultsThe post competency scale consisted of three dimensions (TCM fundamentals and research abilities, TCM thinking and skill abilities, and personal traits and communication abilities) with 21 items. Exploratory factor analysis identified three common factors, accounting for a cumulative variance contribution rate of 62.165%. Confirmatory factor analysis demonstrated that the fit indices of the three-factor model fell within a relatively ideal level. The Cronbach's alpha coefficient of the scale was 0.885. Through convergent validity analysis, the standardized loading coefficients of the 21 items were >0.5, and the average extracted variance (AVE) of the three factors was also >0.5. Moreover, the square roots of the AVE values for each dimension exceeded the correlation coefficients between it and the other dimensions. ConclusionsThe findings suggest that the post competency scale of TCM physicians undergoing standardized training can provide a reliable scientific basis for training and assessment within China.

Remarkable research achievements in traditional Chinese medicine during 2012–2022

Abstract The period since the 18th National Congress of the Communist Party of China (CPC) has witnessed the emerging of innovative achievements in traditional Chinese medicine (TCM). To fulfill the requirements proposed at the 20th National Congress of the CPC and in the Opinions of the CPC Central Committee and the State Council on Promoting the Preservation, Innovation, and Development of Traditional Chinese Medicine and give play to the demonstrative role of major research achievements, the China Association of Chinese Medicine has organized TCM researchers and practitioners to comprehensively review the major research achievements in TCM since the 18th National Congress of the CPC. After collection and organization of achievements, report writing, expert evaluation, and public opinion soliciting, we have compiled the Remarkable Research Achievements of Traditional Chinese Medicine during 2012–2022.

Hot words and overseas hotspots on traditional Chinese medicine in 2020

To analyze the hot words of traditional Chinese medicine (TCM) research and the hotspots of overseas concern in 2020. With the core collection of Web of Science as the data source and 827 TCM-related concepts as the search terms, the research papers related to TCM were obtained through subject search, the authors’ keywords were extracted for frequency statistics, and the top 100 hot words in the field of TCM were obtained. The top 10 overseas hotspots are obtained through cluster analysis. Some suggestions are provided for the hot research areas in the field of TCM.

High-resolution Tandem Mass Spectrometry for Studying Chemical Constituents of Gynura bicolor DC.

The separation and analysis of the desired chemical components are important subjects for the fundamental research of traditional Chinese medicine (TCM). Ultra-high-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS/MS) has gradually become a leading technology for the identification of TCM ingredients. Gynura bicolor DC. (BFH), a perennial stemless herb used for medicine and food in China has medicinal effects such as clearing heat, moistening the lung, relieving cough, dispersing stasis, and relieving swelling. Polyphenols and flavonoids contain numerous isomers, which hinder the identification of the complex compounds in BFH. This paper presents a systematic protocol for studying chemical constituents of BFH based on solvent extraction and integrated data via UPLC-Q-TOF-MS. The method described here includes systematic protocols for sample pretreatment, MS calibration, MS acquisition, data processing, and analysis of results. Sample pretreatment includes collection, cleaning, drying, crushing, and extraction. MS calibration consists of multipoint and single-point correction. Data processing includes data importing, method establishment, analysis processing, and result presentation. Representative results of the typical fragmentation pattern of phenolic acids, esters, and glycosides in Gynura bicolor DC. (BFH) are presented in this paper. In addition, organic solvent selection, extraction, data integration, collision energy selection, and method improvement are discussed in detail. This universal protocol can be widely used to identify complex compounds in TCM.

Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review.

The efficacy and safety of traditional Chinese medicine (TCM) combined with Silibinin in the treatment of nonalcoholic fatty liver disease (NAFLD) are still inconclusive. This meta-analysis intends to evaluation to explore the clinical efficacy and quality assessment of traditional Chinese medicine in combination with Silymarin in the treatment of NAFLD, aiming to aims to provide evidence-based data analysis for researchers and clinical practitioners involved in TCM research for NAFLD, with the hope of facilitating wider adoption and application. In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP and CBM databases from the establishment of the databases to Oct 2023. The study proposed to include studies that reported combination of TCM with Silibinin and Silibinin alone in the treatment of NAFLD, excluding studies for which full text was not available or for which data extraction was not possible; studies using animal studies; reviews and systematic reviews. All data were processed by STATA15.1 statistical software. 16 randomized controlled trials (RCTs) were included in this meta-analysis. The sample size ranged from 48 to 120, with a total of 1335 patients, including 669 in the Combined treatment group and 384 in the Silibinin group. The findings indicated that the total effective rate of combined treatment group was significantly higher than that of Silibinin alone. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), and gamma glutamyl transpeptidase (GGT) of combined treatment group were all significantly lower than that of western medicine alone. Additionally, after treating NAFLD with a combination of TCM and Silibinin, the TCM syndrome score were significantly lower than those observed with Silibinin alone. Traditional Chinese medicine in conjunction with Silibinin capsules has shown significant efficacy in the treatment of NAFLD, improving clinical symptoms, blood lipid levels, and liver function. Furthermore, it is essential to engage in multi-omics research, investigate iron death, and explore the gut microbiota as potential observational indicators for the diagnosis and inclusion criteria. Conducting more high-quality clinical experiments is necessary to further validate these findings.