Utilization Of Traditional Chinese Medicine Research Articles

The long-term trend in utilization of traditional Chinese medicine and associated factors among older people in Taiwan.

Both the size of the older population and the use of complementary and alternative medicine are increasing worldwide. This study evaluated the long-term trend in utilization of traditional Chinese medicine (TCM) and associated factors among older people in Taiwan. Using the database of population-based interview surveys, we evaluated the one-month prevalence of TCM use among 13,945 older people aged over 65 years from 2001-2017. The sociodemographic status and medical comorbidities of older people who did and did not use TCM were compared by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in the multiple logistic regressions. The one-month prevalence of TCM use increased from 5.5% in 2001 to 9.1% in 2017 among older people in Taiwan. Overall, 7.3% of older people had used TCM within the previous month. People with a history of heart disease (OR 1.62, 95% CI 1.24-2.12), use of folk therapy (OR 3.16, 95% CI 2.00-4.99), and purchase of non-prescribed Chinese herbal medicine (OR 2.08, 95% CI 1.48-2.91) were more likely to use TCM than the comparison group. However, age ≥80 years (OR 0.48, 95% CI 0.31-0.72) and previous hospitalization (OR 0.59, 95% CI 0.41-0.85) were associated with the reduced use of TCM. From 2001-2017, the use of TCM increased in the older population in Taiwan. The use of folk medicine and purchase of non-prescribed Chinese herbal medicine were significant predictors for the use of TCM.

Views of Hong Kong Chinese medicine practitioners on the application of the “Chinese Medicine Anti-epidemic Plans” prepared by the Chinese medicine expert group of central authorities: a focus group study

BackgroundDrawing on the extensive utilization of traditional Chinese medicine (TCM) to combat COVID-19 in Mainland China, experts designed a series of TCM anti-epidemic strategies. This study aims to understand Hong Kong CM practitioners’ application of and opinions on the “Chinese Medicine Anti-epidemic Plans.”MethodsOnline focus group interviews were conducted, and purposive sampling was employed to invite 22 CM practitioners to voluntarily participate in three interview sessions. The interviews were audio recorded, then transcribed verbatim. The transcripts were analyzed using template analysis.ResultsThree themes were derived: (1) facilitators of the “Chinese Medicine Anti-epidemic Plans,” (2) barriers of the “Chinese Medicine Anti-epidemic Plans,” and (3) expectations on improving the “Chinese Medicine Anti-epidemic Plans.” The participants could obtain relevant information from various sources, which highlights the value of the plans for TCM medicinal cuisine and non-pharmacologic therapies and guiding junior CM practitioners, supplementing Western medicine interventions, and managing Chinese herb reserves in clinics. However, the barriers included the lack of a specialized platform for timely information release, defective plan content, limited reference value to experienced CM practitioners, and lack of applicability to Hong Kong. The expectations of the CM practitioners for improving the plans were identified based on the barriers.ConclusionsTo enhance the implementation of the anti-epidemic plans, CM practitioners in Hong Kong expect to utilize a specific CM platform and refine the plans to ensure that they are realistic, focused, comprehensive, and tailored to the local context.

Revisiting Traditional Chinese Medicine in Hong Kong during the Influenza Epidemics in the 1950s and 1960s.

This paper examines the supply and utilization of traditional Chinese medicine (TCM) in Hong Kong during the influenza epidemics of the 1950s and 1960s. Existing narratives of TCM in Hong Kong have predominantly framed with within the dichotomy of Western medicine "Xiyi" and Chinese medicine "Zhongyi," portraying TCM as marginalized and nearly wiped out by colonial power. Departing from this binary opposition, this study views TCM as an autonomous space that had never been subjugated by the colonial power which opted for minimal interventionist approach toward TCM. By adopting diachronic and synchronic perspectives on Hong Kong's unique environment shaped by its colonial history and the geopolitics of the Cold War in East Asia, particularly its relationships with "China," this research seeks to reassess the role and status of TCM in post-World War II Hong Kong. In Hong Kong, along with other countries in East Asia, traditional medicine has ceded its position as mainstream medicine to Western medicine. Faced with the crisis of "extinction," Chinese medical professionals, including medical practitioners and merchant groups, persistently sought solidarity and "self-renewal." In the 1950s and 1960s, the colonial authorities heavily relied on private entities, including charity hospitals and clinics; furthermore, there was a lack of provision of public healthcare and official prevention measures against the epidemic influenza. As such, it is not surprising that the Chinese utilized TCM, along with Western medicine, to contain the epidemics which brought about an explosive surge in the number of patients from novel influenza viruses. TCM was significantly consumed during these explosive outbreaks of influenza in 1957 and 1968. In making this argument, this paper firstly provides an overview of the associations of Chinese medical practitioners and merchants who were crucial to the development of TCM in Hong Kong. Secondly, it analyzes one level of active provision and consumption of Chinese medicine during the two flu epidemics, focusing on the medical practices of TCM practitioners in the 1957 epidemic. While recognizing the etiologic agent or agents of the disease as influenza viruses, the group of Chinese medical practitioners of the Chinese Medical Society in Hong Kong adopted the basic principles of traditional medicine regarding influenza, such as Shanghanlun and Wenbingxue, to distinguish the disease status among patients and prescribe medicine according to correct diagnoses, which were effective. Thirdly, this paper examines the level of folk culture among the people, who utilized famous prescriptions of Chinese herbal medicine and alimentotherapy, in addition to Chinese patent medicines imported from mainland China. In the context of regional commercial network, this section also demonstrates how Hong Kong served as a sole exporting port of medicinal materials (e.g., Chinese herbs) and Chinese patent medicines from the People's Republic of China to capitalist markets, including Hong Kong, under the socialist planned or controlled economy in the 1950s and 1960s. It was not only the efficacy of TCM in restoring immunity and alleviating symptoms of the human body, but also the voluntary efforts of these Chinese medical practitioners who sought to defend national medicine "Guoyi," positioning it as complementary and alternative medicine to scientific medicine. Additionally, merchants who imported and distributed Chinese medicinal materials and national "Guochan" Chinese patent medicine played a crucial role, as did the people who utilized Chinese medicine, all of which contributed to making TCM thrive in colonial Hong Kong.

High efficiency removal of ibuprofen in water using activated carbon derived from Radix Angelica Dahurica residue

AbstractThe exploitation and utilization of Traditional Chinese medicine have annually produced 30 million tons of waste residues including Radix Angelica Dahurica residue (RAR), which raised environmental concerns. Meantime, the non‐steroidal anti‐inflammatory drug of ibuprofen (IBP) is an emerging contaminant in the aquatic environment, annually producing up to 9000 tons in China. After extracting the active substance, RAR is prepared as activated carbon (AC) for the purification of IBP wastewater. Two kinds AC modified without (RAR‐AC) and with phosphoric acid (M‐RAR‐AC) were characterized by FT‐IR, TG, BET and SEM. The phosphoric acid activation contributed to the high BET surface area (564.9914 m2 g−1) and large total pore volume (0.4894 cm3 g−1). M‐RAR‐AC showed 7.7 folds (15 min) and 2.7 folds (30 min) higher extent of IBP removal compared to commercial activated carbon (C‐AC). The enhancement of IBP removal with M‐RAR‐AC was investigated further by varying initial pollutant concentration, absorbent dosage, temperature, pH and rotating speed. Especially, temperature nearly has no effect on IBP removal by M‐RAR‐AC. Isotherm and kinetic studies suggested IBP was adsorbed on the heterogeneous surface in multilayer form and chemisorption played the dominant role in IBP removal. IBP removal of 93.3 ± 0.1% and 64.2 ± 2.8% was achieved for first and fifth cycle, respectively. The IBP removal on M‐RAR‐AC may be accomplished by a variety of interactions such as electrostatic attraction, pore‐filling, hydrogen bonding, and π‐π interaction. These findings provide new insights into the utilization of RAR for preparing AC and highlight the potential applications for treating industrial wastewater.

Supply and utilization of traditional Chinese medicine services in the nine Pearl River Delta cities in the Greater Bay Area

Objective: To analyze the present situation of traditional Chinese medicine (TCM) service supply and utilization in 9 cities in the Pearl River Delta (PRD) region of China and provide the specific suggestions for further rational allocation of TCM service resources in the 9 cities in PRD region. Methods: Excel was used to conduct a descriptive statistical analysis of the main indicators of TCM service supply and utilization from 2010 to 2019. Results: In 2019, there were 100 TCM hospitals in the nine cities of the Pearl River Delta in the Greater Bay Area, with the number (0.155) of TCM hospitals for every 100,000 people; and the numbers (0.97 in Zhuhai and 0.19 in Dongguan) of TCM hospital beds for every 1,000 people. The utilization rate of TCM hospital beds was the highest in Zhongshan (93.3%), and the lowest in Huizhou (71.9%) for 10 consecutive years. The city with the highest average daily medical visits was Foshan (4051.2). Conclusion: In Shenzhen and Zhuhai, the input of TCM service personnel and materials is large but the utilization rate is low. The supply of TCM services in Dongguan is insufficient, and there is a huge gap between the demand and the supply. Thus, it is necessary to rationally allocate TCM medical resources, increase the supply of TCM services in some areas, and improve the utilization efficiency of TCM resources.

Analysis on the Selection of Herbs in TCM COVID-19 Treatment Protocols Between Malaysia and China.

Both Malaysian and Chinese populations have benefited from the utilization of Traditional Chinese Medicine (TCM) in the treatment of COVID-19. This study aims to analyze the herb selection in TCM COVID-19 treatment protocols employed by Malaysia and China. Based on TCM theories, a comparative analysis was conducted on the treatment protocols of the two countries. This analysis encompassed syndrome differentiation and classification, therapeutic principles and formulas, as well as herb characteristics. The herbs within the protocols were subjected to frequency statistics and cluster analysis using SPSS 25, and network analysis was performed using SPSS Modeler 18.0 software. The properties (cold, warm, ping and bitter, pungent, sweet) and meridian (lung, stomach, spleen) associated with the herbs in both protocols exhibit fundamental similarities. Furthermore, the propensity for selecting pairs of herbs is also consistent. The herb pairs selected also have the samepropensity. The clustering results reveal six categories, of which in the two protocols are good. The top three herb-pairs in Malaysian Protocols are Gan Cao - Yi Yi Ren, Ban Xia - Gan Cao, Chen Pi - Gan Cao, while the top three in Chinese Protocol are Huo Xiang - Ma Huang, Shi Gao - Gan Cao, Cang Zhu - Gan Cao. Characteristics of herbs in Both Malaysian and Chinese Protocols herb reflect the advantages and regional adaptation of TCM principles. These findings offer valuable guidance in the application of herbs or herb pairs for the treatment of COVID-19.

The intention of utilization and experience toward traditional Chinese medicine among breast cancer patients in the early and late stages: a qualitative study

BackgroundIn Taiwan, breast cancer patients usually take conventional medicine and traditional Chinese medicine simultaneously. The utilization of traditional Chinese medicine among breast cancer patients at various stages has not been examined. This study aims to compare the intention of utilization and experience toward traditional Chinese medicine among early- and late-stage breast cancer patients.MethodThis qualitative research collected data from breast cancer patients through focus groups interview by convenience sampling. Conducted in 2 branches of Taipei City Hospital, a public hospital managed by the Taipei City government. Breast cancer patients > 20 years old and had used TCM for breast cancer therapy for at least 3 months were included in the interview. A semi-structured interview guide was adopted in each focus group interview. In the following data analysis, stages I and II were considered early-stage, and stages III and IV were late-stage. For analyzing the data and reporting the results, we used qualitative content analysis as the approach for data analysis, assisted by NVivo 12. Categories and subcategories were identified through content analysis.ResultsTwelve and seven early- and late-stage breast cancer patients were included in this study, respectively. The side effects were the main intention of utilizing traditional Chinese medicine. Improving side effects and constitution was the main benefit for patients in both stages. Additionally, early-stage breast cancer patients used traditional Chinese medicine to prevent recurrence or metastasis. Late-stage breast cancer patients responded more frequently to the use of traditional Chinese medicine due to the side effects of western medicine. However, some of their symptoms were not fully relieved.ConclusionsBreast cancer staging may influence the intention and utilization of traditional Chinese medicine. Health policymakers should consider the results of this research and the evidence-based illustrations to establish guidelines for integrating traditional Chinese medicine among various stages of breast cancer to improve the outcome and quality of care for cancer patients.

Utilization patterns and prescription characteristics of traditional Chinese medicine among patients with irritable bowel syndrome in Taiwan.

Background: Few studies have investigated traditional Chinese medicine (TCM) utilization patterns for irritable bowel syndrome (IBS), despite the potential benefits of exploring TCM utilization patterns in optimizing TCM management. This study aimed to evaluate TCM utilization patterns and clinical features for IBS patterns in Taiwan. Methods: This was a population-based cross-sectional study using claim data from the National Health Insurance Research Database between 2012 and 2018. Patients newly diagnosed with IBS and aged over 20years were included. The TCM utilization patterns and characteristics, including Chinese herbal medicine (CHM) treatment types and prescription patterns, were evaluated. Results: A total of 73,306 patients newly diagnosed with IBS used TCM for IBS at least once. Females used TCM for IBS more than males (female-to-male ratio = 1.89: 1). The age distribution showed a peak at 30-39years (27.29%), followed by 40-49years (20.74%) and 20-29years (20.71%). Patients who received Western medications for IBS had a lower tendency to seek TCM. CHM was the most commonly used TCM modality (98.22%), with Jia-wei-xiao-yao-san being the most commonly prescribed Chinese herbal formula and Bai-zhu being the most frequently prescribed single Chinese herb. Conclusion: This study enhances our understanding of TCM usage patterns for IBS, particularly CHM prescriptions. Further research is needed to investigate commonly used TCM formulas and individual herbs.

A novel membrane-based integrated process for baicalin recovery from TCM Pudilan wastewater

This study aimed to investigate the potential of membrane integration technology for the recovery of baicalin from Pudilan (PDL) industry wastewater. The impact of different membranes on permeate flux and separation efficiency was analyzed, with fouling mechanisms identified using both resistance-in-series and Hermia models. Results indicate that the CA50k and PES5k combination was suitable for the process. The retentate obtained from the UF membranes contained a significant amount of baicalin, which was subsequently recovered and purified using a straightforward acid precipitation method. The structure of the purified baicalin was identified using 1H NMR and 13C NMR spectra, achieving a maximum recovery rate of 26.15 % with a purity of 93.24 %. The findings of this study have significant implications for the resource utilization of traditional Chinese medicine (TCM) pharmaceutical wastewater.

SSR identification and phylogenetic analysis in four plant species based on complete chloroplast genome sequences

The effective utilization of traditional Chinese medicine (TCM) has been challenged by the difficulty to accurately distinguish between similar plant varieties. The stability and conservation of the chloroplast genome can aid in resolving genotypes. Previous studies using nuclear sequences and molecular markers have not effectively differentiated the species from related taxa, such as Machilus leptophylla, Hanceola exserta, Rubus bambusarum, and Rubus henryi. This study aimed to characterize the chloroplast genomes of these four plant species, and analyze their simple sequence repeats (SSRs) and phylogenetic positions. The results demonstrated the four chloroplast genomes consisted of 152.624 kb, 153.296 kb, 156.309 kb, and 158.953 kb in length, involving 124, 130, 129, and 131 genes, respectively. They also contained four specific regions with mononucleotide being the class with the most members. Moreover, these repeating types of SSR were various in individual class. Phylogenetic analysis showed that M. leptophylla was clustered with M. yunnanensis, and H. exserta was confirmed as belonging to the family Ocimeae. Additionally, R. bambusarum and R. henryi were grouped together but differed in their SSR features, indicating that they were not the same species. This research provides evidence for resolving species and contributes new genetic information for further studies.

Medical care-seeking patterns among women with menstrual syndromes-related diagnoses: a longitudinal population-based study

BackgroundMany women experience menstruation-related health issues during their child-bearing years. This study aimed to evaluate women’s tendency to seek Traditional Chinese Medicine (TCM) and/or Western Medicine (WM) when newly diagnosed with menstrual syndromes and to identify factors associated with their medical care-seeking behaviors.MethodsThe data of a total of 47,097 women aged between 15 and 50 years with newly diagnosed menstrual syndromes in 2005 were extracted from the Taiwan National Health Insurance Database. The follow-up period was divided equally into 6 month segments over 5 years starting with patients’ first visit for obstetric/gynecologic care. Outcomes were outpatient visits and number of TCM or WM visits during each period. Patients’ tendency for medical care utilization was estimated using Poisson regression analysis.ResultsNumber of outpatient visits using TCM was 0.62 (29187/47097), and using WM was 1.67 (78697/47097) within 6 months after the first menstrual syndrome diagnosis. The tendency for TCM utilization increased as follow-up time increased after controlling for potential confounders, while WM utilization decreased as follow-up time increased. Age, economic status, infertility, value of prevention, baby delivery, and obstetric/gynecologic inpatient histories were significantly associated with patients’ medical care-seeking behaviors.ConclusionsTCM and WM medical care-seeking patterns are significantly different among women with diagnoses associated with menstrual syndromes. Related factors affecting medical care-seeking behavior include age, economic status, infertility, value of prevention, childbirth and Ob/Gyn inpatient histories.

Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients.

Objective:To describe patterns of utilization of traditional Chinese medicine (TCM) in the treatment of patients with coronavirus disease 2019 (COVID-19).Methods:Adult patients with COVID-19 who received TCM treatment were divided into a non-serious group (mild and moderate types) and a serious group (severe and critical types) according to their admission conditions. The medical records and prescriptions of these patients were investigated to determine their TCM utilization patterns.Results:In all, 3,872 COVID-19 patients were included. Oral Chinese traditional patent medicine (CPM) was the most commonly used type of TCM, followed by decoction. The proportion of multi-drug combinations was higher than single drug use (55.0% vs. 45.0%). Decoction combined with oral CPM was the most common combination (39.1%, 1,514/3,872). Orally administered, injected, and externally applied CPM were significantly more common in the serious group than in the non-serious, while decoction and non-drug TCM treatments were more common in the non-serious than in the serious group. Multi-drug combinations were used for the majority of patients in both groups, mainly in the form of decoctions combined with oral CPM. Among the serious patients, injected CPM was more often used in patients who died during treatment (35.0%, 36/103). The two most common medication patterns were decoction combined with oral CPM and oral CPM alone in the two finally discharged groups. Oral CPM alone or used in combination with injected CPM were seen most commonly in the death group. Significant differences were established in TCM utilization and medication patterns among patients in three groups who had different prognoses and outcomes.Conclusions:The treatment measures and medication patterns of TCM commonly used in COVID-19 patients with the range of conditions found in this study should be further explored in the future to provide a more complete reference for COVID-19 treatment.

The Beneficial Effects of Chinese Herbal Monomers on Ameliorating Diabetic Cardiomyopathy via Nrf2 Signaling.

Diabetic cardiomyopathy (DCM) is the main factor responsible for poor prognosis and survival in patients with diabetes. The highly complex pathogenesis of DCM involves multiple signaling pathways, including nuclear factor-κB (NF-κB) signaling pathway, adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B (Akt) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and transforming growth factor-β (TGF-β) signaling pathway. Nuclear factor erythroid-2-related factor 2 (Nrf2) seems essential to the amelioration of the progression of DCM, not only through counterbalancing oxidative stress, but also through interacting with other signaling pathways to combat inflammation, the disorder in energy homeostasis and insulin signaling, and fibrosis. It has been evidenced that Chinese herbal monomers could attenuate DCM through the crosstalk of Nrf2 with other signaling pathways. This article has summarized the pathogenesis of DCM (especially in oxidative stress), the beneficial effects of ameliorating DCM via the Nrf2 signaling pathway and its crosstalk, and examples of Chinese herbal monomers. It will facilitate pharmacological research and development to promote the utilization of traditional Chinese medicine in DCM.

Mechanisms by Which Traditional Chinese Medicines Influence the Intestinal Flora and Intestinal Barrier.

The effect of a drug on the intestinal flora and the intestinal barrier is an important evaluation index for drug safety and efficacy. Chemical synthetic drugs are widely used due to their advantages of fast efficacy and low doses, but they are prone to cause drug resistance and inhibit proton pumps, which may harm intestinal health. Traditional Chinese medicine (TCM) has been applied clinically for thousands of years, and how TCMs regulate intestinal health to achieve their effects of disease treatment has become a hot research topic that needs to be resolved. This paper reviews the recent research on the effects of TCMs on intestinal microorganisms and the intestinal mucosal barrier after entering the intestine, discusses the interaction mechanisms between TCMs and intestinal flora, and details the repair effect of TCMs on the intestinal mucosal barrier to provide a reference for the development, utilization, and modernization of TCM.

Traditional Chinese Medicine and Colorectal Cancer: Implications for Drug Discovery.

As an important part of complementary and alternative medicine, traditional Chinese medicine (TCM) has been applied to treat a host of diseases for centuries. Over the years, with the incidence rate of human colorectal cancer (CRC) increasing continuously and the advantage of TCM gradually becoming more prominent, the importance of TCM in both domestic and international fields is also growing with each passing day. However, the unknowability of active ingredients, effective substances, and the underlying mechanisms of TCM against this malignant tumor greatly restricts the translation degree of clinical products and the pace of precision medicine. In this review, based on the characteristics of TCM and the oral administration of most ingredients, we herein provide beneficial information for the clinical utilization of TCM in the prevention and treatment of CRC and retrospect the current preclinical studies on the related active ingredients, as well as put forward the research mode for the discovery of active ingredients and effective substances in TCM, to provide novel insights into the research and development of innovative agents from this conventional medicine for CRC treatment and assist the realization of precision medicine.

A comprehensive study of three species of Paeonia stem and leaf phytochemicals, and their antioxidant activities

Ethnopharmacological relevancePaeonia plants have been widely used as traditional Chinese medicinal materials for more than 2,000 years in the treatment of cardiovascular, extravasated blood and female genital diseases; paeoniflorin and paeonol have been implicated as the plants’ primary active ingredients. Aim of the studyPrevious studies have been singularly focused on the chemical constituents and content variation of the Paeonia roots in the advancement of traditional Chinese medicine, with the plants’ stems and leaves considered useless. This study aims to explore the chemical constituents, content variation, and antioxidant capacity in Paeonia stems and leaves for the future utilization of traditional Chinese medicine, given that current practices of digging and trade endanger Paeonia in the wild. Materials and methodsHerein, secondary metabolites from the stems and leaves from six developmental stages of the annual growth cycle of Paeonia ostii T. Hong & J. X. Zhang, P. ‘Hexie’, and P. lactiflora Pall. were qualitatively and quantitatively analyzed via high-performance liquid chromatography with a diode array detector (HPLC-DAD) and high-performance liquid chromatography quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS). Antioxidant capacity at each stage was also evaluated by various free radical scavenging assays. ResultsA total of 24 metabolites were detected and identified, including 5 monoterpene glycosides, 4 tannins, 5 phenols, 9 flavonoids, and paeonol. Excepting paeonol and the phenols, the levels of each metabolite category were significantly higher in the leaves than the stems during all developmental stages. The paeoniflorin content in the P. ostii leaves was the highest during the first developmental stage and higher than the standards of the Chinese Pharmacopoeia, suggesting it to be the optimal harvesting stage for medicinal uses. Notably, the antioxidant capacity of the leaves was significantly greater than in the stems, particularly for the leaves of P. ‘Hexie’. ConclusionOur study indicates that the leaves of P. ‘Hexie’ have the potential to be a worthy medicinal substitute to Paeonia roots due to their high monoterpene glycosides, phenols, and flavonoids as well as their strong antioxidant capacity. Further, this study provides a theoretical basis for the development and utilization of non-root Paeonia plant sections as medicinal plant resources.

The dynamics of patient visits to traditional Chinese medicine during the 2019 coronavirus pandemic

BackgroundLarge-scale epidemics have changed people’s medical behavior, and patients tend to delay non-urgent medical needs. However, the impact of the pandemic on the use of complementary and alternative medicine remains unknown.MethodsThis retrospective study aimed to analyze the changes in the number of traditional Chinese medicine (TCM) patients and examine the epidemic prevention policy during the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the number of TCM patients in Taipei City Hospital from January 2017 to May 2020. We tallied the numbers of patients in each month and compared them with those in the same months last year. We calculated the percentage difference in the number of patients to reveal the impact of the COVID-19 pandemic on TCM utilization. We used the Mann–Whitney U test to examine whether there was a significant difference in the number of patients during the COVID-19 pandemic.ResultsWe included a total of 1,935,827 TCM visits of patients from January 2017 to May 2020 in this study. During the COVID-19 pandemic, the number of patients decreased significantly, except in February 2020. The number of patients during the COVID-19 pandemic had fallen by more than 15% compared with those in the same months last year. March and April had the greatest number of patient losses, with falls of 32.8 and 40% respectively. TCM patients declined significantly during the COVID-19 pandemic, and mobile medicine provided to rural areas fell considerably. Among all the TCM specialties, pediatrics and traumatology, as well as infertility treatment, witnessed the most significant decline in the number of patients. However, the number of cancer patients has reportedly increased.ConclusionsThe COVID-19 pandemic decreased the utilization rate of TCM, especially for mobile healthcare in rural areas. We suggest that the government pay attention to the medical disparity between urban and rural areas, which are affected by the pandemic, as well as allocate adequate resources in areas deprived of medical care.

Treatment of wastewater generated from traditional Chinese medicine processing and utilization: Recent advances and future outlook

Nowadays, traditional Chinese medicine plays an important role in curing many diseases, and its market expands quickly due to the potential great profits it can bring. To be an attractive industry, both economic and environmental aspects should be considered. As wastewater is usually generated from traditional Chinese medicine processing and utilization, its treatment is one of the hot research topics in environmental engineering currently. Many technologies can be applied for the treatment of this wastewater, but the technical background and performance vary greatly especially for different kinds of wastewater. In this situation, a systematical and comprehensive summary for the development of these technologies is necessary. In this review article, the sources of wastewater from the processing and utilization of traditional Chinese medicine are introduced firstly to show where this wastewater comes from. And then, the recent advances on the technologies for the treatment of this wastewater are introduced in detail to show what technologies can be applied. At last, the future outlook for the development of these treatment technologies is given to discuss how to fulfill their industrial application. Overall, this review article can present some important information for building a clean and sustainable traditional Chinese medicine industry. • Traditional Chinese medicine processing and utilization generate wastewater. • Potential sources of different kinds of wastewater are introduced. • Technologies for this wastewater treatment are discussed systematically. • Outlook for fulfilling industrial application of different technologies is given. • Effective and efficient technologies integration is shown comprehensively.

Traditional Chinese medicine on treating premenstrual syndrome and premenstrual dysphoric disorder: A protocol for systematic review and meta-analysis.

Background:Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common disorders that manifest themselves in the late luteal phase, and significantly interfere with an individual's daily activities. Clinical evidence suggests that traditional Chinese medicine (TCM) may ease PMS/PMDD symptoms. Here, we review a protocol for exploring the effectiveness and safety of TCM in PMS/PMDD management.Methods:We will conduct a literature search for randomized controlled trials (RCT) for TCM use in PMS/PMDD on PubMed, web of science, EMBASE, the Cochrane central register of controlled trials (Cochrane Library), Chinese national knowledge infrastructure, Chinese VIP Information, Wanfang, as well as Chinese biomedical literature database. The search included all relevant reports for up to June 1, 2020. The search results were independently analyzed by 2 reviewers who extracted the data. RCT quality will be assessed using the risk-of-bias tool. The evidence will be inspected using the grading of recommendations assessment development and evaluation (GRADE). We will utilize Stata and Revman for systematic review and meta-analysis and analysis of direct and indirect evidence.Results:Based on current evidence, this study will elucidate the rationale for the utilization of TCM in PMS/PMDD treatment.Conclusion:Conclusions from this study will inform about the effectiveness and safety of TCM in PMS/PMDD management.Trial registration number:CRD42020192822.Ethics and dissemination:Since all data utilized in this systematic review and meta-analysis are published, ethical approval is not needed. Additionally, in the trial of the review process, all data will be evaluated anonymously.

Risk of diabetes in stroke patients who used Bu Yang Huan Wu Tang: A nationwide propensity-score matched study

BackgroundThe utilization of traditional Chinese medicine is a common therapeutic approach for stroke patients in Chinese population, but little is known about the effect of Bu Yang Huan Wu Tang (BYHWT) on post-stroke diabetes. PurposeWe aimed to evaluate the risk of diabetes in stroke patients who used BYHWT. Study designA retrospective cohort study based on a real-world database was conducted. MethodsNewly diagnosed stroke patients receiving inpatient care from 2000 to 2004 were identified using a large-scale insurance database in Taiwan. Propensity score matching was used to select eligible stroke patients who did (n = 9849) and did not (n = 9849) receive BYHWT. These two groups were followed up until the end of 2009 to track incident diabetes. Cox proportional hazard models were used to calculate the adjusted hazard rations (HRs) and 95% confidence intervals (CIs) for post-stroke diabetes associated with BYHWT during the follow-up period. ResultsStroke patients who used BYHWT had a reduced incidence of diabetes (14.1% vs. 19.0%, p < 0.0001) and reduced risk of diabetes (HR 0.77; 95% CI 0.72 to 0.83) compared with the control group. The association between BYHWT and reduced risk of post-stroke diabetes was significant across sexe, age group, and stroke subtype. Additionally, the use of BYHWT was associated with a reduced risk of post-stroke diabetes even after excluding the initial three months of diabetes cases in the sensitivity analysis. ConclusionsStroke patients who received BYHWT therapy had a reduced risk of diabetes, and a positive effect was observed in various subgroups. However, future clinical trials will be necessary to validate the present findings and identify the biochemical mechanism involved.