Western Medicine Treatment Research Articles

Contribution of traditional Chinese medicine combined with conventional western medicine treatment for the novel coronavirus disease (COVID-19), current evidence with systematic review and meta-analysis.

This study provides current evidence for efficacy and safety of treating COVID‐19 with combined traditional Chinese medicine (TCM) and conventional western medicine (CWM). Six databases were searched from January 1 to December 31, 2020. Randomized controlled trials (RCTs), case–control studies (CCTs), and cohort studies on TCM or TCM combined with CWM treatment for COVID‐19 were included. The quality of included RCTs was assessed by Cochrane risk of bias tool, and the Newcastle‐Ottawa Scale (NOS) was used to assess the quality of cohort studies and CCTs. Review Manager 5.4 software was used to perform meta‐analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A total of 35 studies (3,808 patients) composing 19 RCTs and 16 observational studies were included. The results of meta‐analysis revealed that comparing with CWM alone, integrated TCM and CWM had significant improvement in total effective rate, improvement rate of chest CT, the rate of disease progression, as well as improvement of fever, fatigue and cough. The overall quality of evidence was very low to moderate. In conclusion, TCM combined with CWM was a potential treatment option for increasing clinical effective rate, improving the clinical symptoms, and preventing disease progression in COVID‐19 patients. High‐quality clinical trials are required in the further.

Spectrum-effect relationship between UHPLC-Q-TOF/MS fingerprint and promoting gastrointestinal motility activity of Fructus aurantii based on multivariate statistical analysis

Ethnopharmacological relevanceNowadays, gastrointestinal motility disorders (GMD) have reduced the quality of people's daily life worldwide, but there is still a lack of effective western medicine treatment. Fructus aurantii (FA), a representative regulating-qi herbal medicine, has been widely used to treat GMD in China for thousands of years, but it is not clear that which specific components contribute to the efficacy. Aim of the studyThe efficacy differences of various fractions of FA on normal mice and GMD rats were compared, so as to find out the main effective fraction of FA, and to screen the main regulating-qi components based on spectrum-effect relationship and multivariate statistical analysis. Materials and methodsThe fingerprints of different fractions of FA were established and main compounds were identified with UHPLC-Q-TOF/MS technique. The promoting gastrointestinal motility activities of FA were evaluated by defecation test, gastric emptying and intestinal propulsion test in mice, and further investigated according to the biochemical analysis of 5-HT, SP, MLT, GAS and VIP in GMD rats’ plasma. One-way ANOVA was used to find out the difference of efficacy. The active components were screened through spectrum-effect relationship with PCA-X, Pearson bivariate correlation analysis and OPLS analysis. ConclusionsEthyl acetate fraction is the main active fraction, and nine compounds are the major regulating-qi components. The developed spectrum-effect analysis can be used for the screening of bioactive components in natural products with high accuracy and reliability.

Improvement of Acupuncture Based on Smart Medical Care for Post-Stroke Hemiplegic Shoulder Pain and Upper Limb Motor Function.

As a new stage in the development of medicine and health, smart medicine has attracted attention from all parties in recent years. Especially, under the impetus of the Internet, due to the development of new technologies, smart medical care has made considerable progress, and it has also brought us new challenges. The concept, hypothesis, and design of intelligent medical care are analyzed, and the design objects and design principles of intelligent medical care are highlighted. In Africa, 79 patients with shoulder pain after stroke and hemiplegia in the recession period were disintegrated and divided into observation group (40 people) and control group (39 people). The observation group and the control group used two different treatment methods, acupuncture treatment and traditional western medicine treatment. Finally, the situation of the two groups is checked. From the results, the treatment effect of the control group was not as good as that of the observation group (P < 0.05). After treatment, the effects of capillary disease and patients' living conditions in the observation group were better than those in the control group (P < 0.05). It is concluded that the therapeutic effect of wisdom acupuncture treatment has a certain effect and can be used in medical treatment.

The Effectiveness and Safety of Bushen Huoxue Decoction on Treating Coronary Heart Disease: A Meta-Analysis.

Objective The aim of this meta-analysis was to systematically evaluate the effectiveness and safety of the traditional Chinese medicine (TCM) formula Bushen Huoxue Decoction (BSHXD) in treating coronary heart disease (CHD). Methods Randomized controlled trials (RCTS) of BSHXD in treating CHD were searched until March 2020, through six electronic databases: PubMed, Cochrane Library, CNKI, WanFang, SinoMed, and VIP. This study used the Cochrane Risk Test bias tool in the Cochrane Handbook to assess the quality of the methodology. Review Manager (RevMan) 5.3 was used to analyze the results. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied in the classification of evidence quality. Results Ten RCTs involving 901 patients were finally included in this meta-analysis. It revealed that the effectiveness of BSHXD in treating CHD was significantly better than that of the conventional western medicine (CWM) treatment (P < 0.00001). The effective rate of BSHXD treatment group on ECG was also significantly higher than that of CWM group (P < 0.00001). The low-density lipoprotein cholesterol was decreased in the treatment groups compared with those in the control groups (P < 0.00001). There was also a reduction in frequency and duration of angina pectoris (P < 0.00001). There were no significant differences in TC level (P=0.08), TG level (P=0.86), and HDL level (P=0.76) between the treatment and control groups. Five studies had informed adverse events, including nausea and diarrhea. Conclusion Our findings laid the foundation to the use of TCM Formula BSHXD in combination with conventional western medicine for treating CHD. However, due to the limitation of the quality of the included researches, in addition to potential reporting bias, the above conclusions still need verification by higher-quality and better-designed studies.

Meta analysis on the treatment of coronavirus disease 2019 by traditional Chinese and Western medicine

To evaluate the clinical efficacy and safety of combination of traditional Chinese and Western medicine in the treatment of coronavirus disease 2019 (COVID-19) by Meta analysis. The clinical randomized controlled trials (RCT) and cohort studies on the treatment of COVID-19 with combination of Chinese traditional and Western medicine published on CNKI, Wanfang database, VIP database and PubMed were searched by computer from January 2020 to June 2020. Patients in the simple Western medicine treatment group were treated with routine treatment of Western medicine, and the patients in integrated traditional Chinese and Western medicine treatment group were treated with traditional Chinese medicine on the basis of routine treatment of Western medicine. The main outcome was the total effective rate of treatment. The secondary outcome were the antipyretic rate, chest CT recovery rate, lymphocyte count (LYM), C-reactive protein (CRP) level and safety. The Cochrane manual and the Newcastle Ottawa Scale (NOS) were used to evaluate the quality of the literature; the RevMan5.3 software was used to analyze the articles that meets the quality standards, and a funnel chart was drawn to evaluate the total effective publication bias. Thirteen articles were analyzed, including 1 039 COVID-19 patients, 559 in integrated traditional Chinese and Western medicine treatment group and 480 in simple Western medicine treatment group. The results of Meta- analysis showed that compared with the simple Western medicine treatment group, the combination of routine treatment of Western medicine and traditional Chinese medicine Qingfei Paidu decoction, Lianhua Qingwen granule, Shufeng jiedu capsule, Xuebijing injection or Reyanning mixture could significantly improve the total effective rate, antipyretic rate and chest CT recovery rate [total effective rate: odds ratio (OR) = 2.95, 95% confidence interval (95%CI) was 2.10-4.14, P < 0.000 01; antipyretic rate: OR =3.01, 95%CI was 1.64-5.53, P = 0.000 4; chest CT recovery rate: OR = 2.53, 95%CI was 1.83-3.51, P = 0.000 1], increase LYM levels [mean difference (MD) = 0.26, 95%CI was 0.02-0.50, P = 0.03], and reduce of CRP content (MD = -17.68, 95%CI was -33.14 to -2.22, P = 0.02). Based on the funnel chart analysis of 12 articles with total efficiency, the result showed that the funnel chart distribution was not completely symmetrical, indicating that there might be publication bias. On the basis of routine treatment with Western medicine, combined with traditional Chinese medicine can significantly improve the total effective rate of COVID-19 and improve the laboratory results and clinical symptoms of patients. Compared with the routine treatment of Western medicine alone, the combination of traditional Chinese and Western medicine has better clinical efficacy and safety.

Therapeutic effects of Yiqi Huoxue prescription on diabetic nephropathy: a meta-analysis and systematic review

Traditional Chinese medicine (TCM) has demonstrated excellent effects in treating diabetic nephropathy, and Yiqi Huoxue prescription has been widely used clinically. In the study, its effects on the kidney function and blood glucose of patients were explored.Chinese and English databases including PubMed, Medline, Embase, and Web of Sciences were used to retrieve articles comparing the treatment of diabetic nephropathy using Yiqi Huoxue prescription on the basis of conventional Western medicine treatment (experimental group) and conventional Western medicine treatment alone (control group) published from January 2000 to December 2020. The risk of bias assessment tool of the Cochrane System Review Manual 5.2.2 and the Jadad scale were used to evaluate the quality of the included literature. The outcome indexes were extracted, and the Review Manager 5.3 software was used for meta-analysis.A total of 13 articles that satisfied the inclusion/exclusion criteria were included in this study. After treatment, compared to the control group, the experimental group exhibited lower urine microalbumin excretion rate (UAER) [mean difference (MD) =-33.94, 95% confidence interval (CI), -42.60 to -25.28, P<0.00001], serum creatinine (SCr) (MD =-7.43, 95% CI, -11.50 to -3.36, P=0.0004), blood urea nitrogen (BUN) (SMD =-1.23, 95% CI, -2.49 to 0.03, P=0.04), blood glucose-related indexes [fasting blood glucose (FBG)] (MD =-0.43, 95% CI, -0.87 to 0.01, P=0.03), glycosylated hemoglobin (HbA1c) (MD =-0.38, 95% CI, -0.68 to -0.08, P=0.01), blood lipid-related indexes [triglycerides (TG)] (MD =-0.44, 95% CI, -0.76 to -0.13, P=0.006), and serum total cholesterol (TC) (MD =-0.37, 95% CI, -0.57 to -0.18, P=0.0002). Furthermore, the experimental group also showed higher effectiveness rate (odds ratio =3.81, 95% CI, 2.71 to 5.35, P<0.00001) after treatment.The included literature had low bias risk. Yiqi Huoxue prescription on the basis of conventional Western medicine can significantly improve the renal function and reduce the levels of blood glucose and blood lipids of patients with diabetic nephropathy.

APPLICATION OF CHEN YUANGAO IN THE TREATMENT OF SOFT TISSUE INJURY OF FOOTBALL PLAYERS

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.

Clinical Observation on the Treatment of Hypertension by Combination of Modified Banxia Baizhu Tianma Decoction and Auricular Acupuncture

Objective: To observe the curative effect of Jiawei Banxia Baizhu Tianma Decoction (BBTD) in combination with auricular acupuncture in the treatment of primary hypertension with phlegm-dampness syndrome. Methods: 120 patients with hypertension were randomly divided into a pure Western medicine treatment control group (referred to as the control group) and an integrated traditional Chinese and Western medicine treatment group (referred to as the treatment group), with 60 cases in each group. The control group was given nifedipine sustained-release tablets orally; the treatment group: nifedipine sustained-release tablets were given on the basis of modified BBTD combined with auricular acupuncture. The treatment course duration of the two groups was 4 weeks. Before and after treatment, the two groups were evaluated for treatment efficacy and quality of life. Results: There is statistically significant difference in blood pressure lowering between the treatment group and the control group (P?0.05); the treatment group was better than the control group in symptoms improvement of the patients (P?0.05); in terms of the improvement in quality of life , the treatment group was significantly better than the control group (P?0.05, P?0.01). Conclusion: Modified BBTD combined with auricular acupuncture method can reduce blood pressure and improve clinical symptoms in patients with primary hypertension with phlegm-dampness syndrome, and significantly improve the quality of life of patients.

Analysis on the Law of Chinese Medicine Use of Ulcerative Colitis and TCM Syndrome Differentiation and Treatment

Ulcerative colitis is a kind of inflammatory bowel disease. The disease is slow and easy to relapse. Western medicine treatment mainly focuses on symptomatic treatment, which has certain side effects on liver and kidney function. Ulcerative colitis has unique advantages in disease, so by studying a large amount of information, mainly from the law of traditional Chinese medicine use of UC, and a brief summary of the treatment of TCM syndromes, this article provides ideas and basis for clinical diagnosis and treatment of the disease.

Acupotomy for Osteoarthritis of the Knee; A Systematic Review and Meta-Analysis

The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (&gt; 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future.

Combination of acupuncture with rehabilitation training for pseudobulbar paralysis after stroke:A randomized controlled trial吞咽五穴联合康复训练 治疗脑卒中后假性延髓麻痹：随机对照试验

ObjectiveTo compare the clinical effects of needling at “five acupoints for swallow function” combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke. MethodsSeventy-six patients were randomized into rehabilitation group and combination group, with 38 cases in each. Both groups were treated with basic treatment of western medicine. The rehabilitation group was treated with routine rehabilitation training, and the combination group was treated with acupuncture at “five acupoints for swallow function” based on treatment in the rehabilitation group. Patients in the two groups were treated once a day, 6 days a week, 1 day for rest, for 3 weeks in succession. The changes in the grades and scores of water swallow test (WST), video fluoroscopic swallowing study (VFSS), and swallowing quality of life questionnaire (SWAL-QOL) in the two groups were observed before and after treatment, and the clinical effects of the two groups were compared. ResultsAfter treatment, the WST grades of the two groups were statistically different from that of before treatment (both P< 0.05), and the WST grade of the combination group was statistically different from that of the rehabilitation group (P< 0.05). After treatment, the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment (all P < 0.05), and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group (both P < 0.05). The total effective rate of the combination group was 92.1% (35/38), higher than 60.1% (23/38) of the rehabilitation group. ConclusionThe acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only. The combination of the two can significantly relieve the dysphagia and improve the patients’ quality of life.

Systematic evaluation on efficacy and safety of Gingko Ketone Ester Dropping Pills in treatment of angina pectoris and coronary heart disease

To systemically evaluate the efficacy and safety of Gingko Ketone Ester Dropping Pills in treating angina pectoris and co-ronary heart disease. CNKI, Wanfang, SinoMed, PubMed, Cochrane Library and EMbase databases were retrieved on computer, and the randomized clinical trial(RCT) on Gingko Ketone Ester Dropping Pills in treating angina pectoris and coronary heart disease, which were published from the database establishment to December 31, 2019, were comprehensively collected. Literature screening, data extraction and quality evaluation were conducted independently by two researchers according to inclusion and exclusion criteria. Literature methodology quality evaluation was conducted with use of the Cochrane Handbook 5.3.0(bias risk assessment tool). Meta-analysis was performed with RevMan 5.3.0 software. A total of 10 RCTs were included. The results of the Meta-analysis showed that as compared with conventional Western medicine alone, the application of Gingko Ketone Ester Dropping Pills combined with conventional Western medicine treatment further improved the total effective rate and electrocardiogram effect(RR=1.43,95%CI[1.20,1.71],P&lt;0.000 1). There were statistically significant differences in the number of angina attacks, the duration of angina and the amount of nitroglycerin used. In terms of safety indicators, four studies reported adverse reactions in the experimental group, including facial flu-shing, tachycardia, dizziness, dyspnea, nausea and other symptoms. Based on the existing findings, in the treatment of angina pectoris and coronary heart disease, Gingko Ketone Ester Dropping Pills combined with conventional Western medicine can improve the clinical total effective rate, electrocardiogram effect, number of angina attacks, duration of angina and the amount of nitroglycerin used. However, in the included studies, due to some methodological quality problems which would impact the reliability of literature results more high-quality randomized controlled trials are still needed for further verification.

Characteristics of 1738 Patients With Coronavirus Disease 2019 (COVID-19) in Wuhan, China.

Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been discovered in Wuhan and spread rapidly across China and worldwide. Characteristics of infected patients are needed to get insight into the full spectrum of the disease. Epidemiological and clinical information of 1738 diagnosed patients during February 7-26, 2020 in Wuhan Dongxihu Fangcang Hospital were analyzed. A total of 709 patients were followed up on symptom, mental health, isolation site, and medication after discharge. There were 852 males and 886 females in the cohort. The average age of the patients was 48.8 y. A total of 79.98% of the patients were from Wuhan, Hubei Province. The most common initial symptoms were fever, cough, and shortness of breath. Among all the patients, 1463 had complications, with respiratory distress as the most common complication. The average duration of hospitalization was 15.95 ± 14.69 d. The most common postdischarge symptom is cough. After discharge, most patients were full of energy and chose hotel as their self-isolation site. Coronavirus disease 2019 (COVID-19) Chinese medicine No.2 prescription is the medication used most commonly by the patients after discharge. The population is generally susceptible to SARS-CoV-2. After receiving aggressive treatment of combined Chinese and Western medicine, most patients had a good prognosis and mental health after discharge.

Complementary and Alternative Medicine for the Treatment of Abnormal Endometrial Conditions in Women with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background Endometrial lesions in patients with polycystic ovary syndrome (PCOS) exhibit complex pathological features, and these patients are at risk of both short-term and long-term complications. Complementary and alternative medicine (CAM), which is gradually becoming more accepted and is believed to be clinically effective, claims to be promising for treating PCOS, and thus its effect on the abnormal endometrium of PCOS patients should be assessed. The present meta-analysis sought to evaluate the efficacy and safety of CAM in treating endometrial lesions in patients with PCOS. Methods Randomized trials on CAM were identified in four Chinese and seven English-language databases from their establishment to January 2020. The present study included patients diagnosed with PCOS and abnormal endometrial conditions who underwent CAM therapy independently or in combination with traditional western medicine. Data were extracted, and the Cochrane “risk of bias” tool was used to assess methodological quality. Effects were expressed as the relative risk (RR) or mean difference (MD/SMD) with 95% confidence interval (CI) as calculated with Rev Man 5.3. Results A total of 13 randomized controlled trials were included, involving 1,297 PCOS patients treated for endometrial abnormalities. Methodological quality was generally unclear or had a low risk of bias. The trials tested four different types of CAM therapies (i.e., traditional Chinese medicine treatment, acupuncture treatment, traditional Chinese medicine in combination with western medicine treatment, and acupuncture in combination with western medicine treatment). CAM treatment could significantly reduce the endometrial thickness in PCOS patients compared to western medicine alone (SMD −0.88, 95% CI [−0.12, −0.57]; I2 = 64%). Compared with clomiphene treatment for the induction of ovulation, CAM treatment showed a clear improvement in endometrial thickness during ovulation (SMD 2.03, 95% CI [1.64, 2.02]; I2 = 48%). Moreover, CAM was more effective than western medicine alone in reducing the endometrial spiral artery pulsatility index. No significant difference was seen between CAM and traditional treatment when these were used to improve traditional Chinese medicine syndrome scores. Acupuncture alone or traditional Chinese medicines (taken orally) in combination with western medicine significantly increased the pregnancy rate of PCOS patients (RR 1.59, 95% CI [1.30, 1.93]; I2 = 51%, P < 0.00001), and CAM was more effective than western medicine alone for improving hormone levels. No serious adverse events were reported in 11 of the 13 trials. Conclusions CAM may effectively ameliorate the endometrial condition of PCOS patients, and it can regulate the level of hormone secretion to increase the ovulation rate and the pregnancy rate.

Comparison of the clinical features and therapeutics of COVID-19 in cardio-cerebrovascular disease (CCVD) and non-CCVD patients.

Cardio-cerebrovascular disease (CCVD) is a major comorbidity of Coronavirus disease 2019 (COVID-19). However, the clinical characteristics and outcomes remain unclear. In this study, 102 cases of COVID-19 from January 22, 2020 to March 26, 2020 in Xixi Hospital of Hangzhou were included. Twenty cases had pre-existing CCVD. Results showed that compared with non-CCVD patients, those with CCVD are more likely to develop severe disease (15% versus 1%), and the proportion of pneumonia severity index grade IV was significantly higher (25% versus 3.6%). Computed tomography images demonstrated that the proportion of multiple lobe lesion involvement was significantly higher in the CCVD group than in the non-CCVD group (90% versus 63.4%). Compared with non-CCVD group, the levels of C-reactive protein, fibrinogen, D-dimer, and serum amyloid-A were higher, whereas the total protein and arterial partial PaO2 were lower in the CCVD group. Although no statistical difference was observed in the outcomes between groups, CCVD patients received more intensive comprehensive treatment to improve COVID-19 symptoms compared with non-CCVD patients. Integrated Chinese and Western medicine treatments have certain advantages in controlling the severe conversion rate and mortality of COVID-19. In addition, given that COVID-19 patients are usually related to coagulation disorders and thrombosis risk, the application of Chinese medicine in promoting blood circulation and removing stasis should be strengthened.

Linggui Zhugan Decoction for peripheral vertigo: A protocol for systematic review and meta-analysis.

Background:Vertigo is a sense of movement or rotation of the patient's own or an external object. At present, western medicine treatment such as vestibular suppressant medications commonly used in clinical practice are ineffective and have adverse reactions. In traditional Chinese medicine, Linggui Zhugan Decoction (LZD) was used by doctors to warm yang for resolving fluid retention, strengthen the spleen and clear away dampness, with significant effect. Recently, some clinical studies have also shown that LZD has reliable effect in treating peripheral vertigo, but there is no systematic evidence. Therefore, this study aims to objectively evaluate the efficacy and safety of LZD in the treatment of peripheral vertigo.Methods:Eight electronic databases will be searched from inception to August 2020 by 2 independent researchers, in order to collect qualified randomized controlled trials (RCTs) on the LZD treatment for peripheral vertigo. The therapeutic effects according to Clinical efficacy will be adopted as the primary outcomes. RevMan V.5.3 software will be used for the data synthesis and the Cochrane's risk of bias assessment tool will be used to assess the risk of bias.Results:This review will conduct a high-quality synthesis on present evidence of LZD for peripheral vertigo.Conclusion:The conclusion of the study will indicate whether LZD is an effective treatment for peripheral vertigo by providing updated evidence.PROSPERO registration number:PROSPERO CRD 42021238817.

Study on the effect of integrated traditional Chinese and western medicine in the treatment of brucellosis

Objective: To observe the clinical effect of integrated traditional Chinese and western medicine on brucellosis and its influence on humoral immune indexes. Methods: In October 2019, 169 cases of brucellosis hospitalized in Tianjin Second People's Hospital were selected as the research objects, and divided into two groups according to the random number method, 84 cases in the integrated treatment group and 85 cases in the western medicine treatment group. The western medicine treatment group was given antibiotics and other routine western medicine support treatment. The integrated treatment group was given traditional Chinese medicine for treatment based on syndrome differentiation, on the basis of western medicine treatment group, and 6 weeks was a course of treatment. The clinical efficacy and Traditional Chinese Medicine (TCM) syndrome scores were compared between the two groups of patients after treatment, and the changes in humoral immune indexes, biochemical, and liver and kidney functions of the patients before and after treatment were analyzed. Results: The total effective rate was 100.00% (84/84) in the integrated treatment group and 97.65% (83/85) in the western medicine treatment group. The difference was not statistically significant (P>0.05) . The difference was not statistically significant (P>0.05) . There was no statistically significant difference in TCM syndrome scores between the two groups before treatment (P>0.05) , and the TCM syndrome scores after treatment were lower than before treatment (P<0.05) . Among them, the TCM syndrome scores of the integrated treatment group were lower than those of the western medicine treatment group (P<0.05) . There was no significant difference in IgG, IgA, IgM, C3, C4, miRNA-155, C-reactive protein (CRP) , erythrocyte sedimention rate (ESR) , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) between the two groups before treatment (P>0.05) . After treatment, IgG, IgA, IgM, miRNA-155, CRP, ESR, ALT and AST were all lower than before treatment, and C3 and C4 complement levels were higher than before treatment (P<0.05) . Among them, IgG, IgA, IgM, miRNA-155, CRP, ESR, ALT and AST in the integrative treatment group were all lower than the western medicine treatment group, while the C3 and C4 complement levels were higher than the western medicine treatment group (P<0.05) . Conclusion: The treatment of brucellosis with integrated traditional Chinese and western medicine can significantly improve the TCM syndrome score and reduce the levels of CRP and ESR. The mechanism of action may be related to the regulation of the patient's humoral immunological indicators.

Clinical observation of acupuncture bloodletting at Ashi points on local swelling and pain after snakebite: 阿是穴针刺放血治疗蛇伤局部肿痛临床疗效观察

ObjectiveTo evaluate the clinical therapeutic effect of acupuncture bloodletting therapy on local swelling and pain of snakebite in the patients bitten by snakes. MethodsA total of 106 patients with trimeresurus stejnegeri bite were randomly divided into two groups, a conventional treatment group and a conventional treatment combined with bloodletting therapy group, 53 cases in each one. In the conventional treatment group, the convention treatment of western medicine was adopted. In the conventional treatment combined with bloodletting therapy group, on the base of the conventional treatment, bloodletting therapy was applied at Ashi points selected at the tender points around the wound. The intervention and observation were performed not less than 7 days in two groups. Before and after treatment, swelling and pain degrees were measured and remission time of both the limb swelling and pain were recorded in the patients. ResultsCompared with the values on day 1 of treatment, swelling degree and visual analogue scale (VAS) score of the upper and lower limbs were all lower on day 3 and day 7 of treatment in the patients of the two groups (all P < 0.05). Compared with the conventional treatment group, swelling degree and VAS score of the upper and lower limbs were all lower in the values of the conventional treatment combined with bloodletting therapy group on day 3 and day 7 of treatment respectively (all P < 0.05). The remission time of either limb swelling or pain in the patients of the conventional treatment combined with bloodletting therapy group was shorter than the conventional treatment group respectively (both P < 0.05). ConclusionAcupuncture bloodletting therapy can effectively relieve the local swelling and pain caused by snakebite, promote the recovery of limb function, shorten the treatment course and improve the clinical therapeutic effect.

Pharmacoeconomic evaluation of Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment for coronary heart disease by Markov model

This research was to evaluate the economics of Shexiang Tongxin Dropping Pills combined with conventional therapy for patients with coronary heart disease(CHD) in Chinese medical environment. From the perspective of medical insurance, a Markov model was established in this study based on the results of Meta-analysis comparing the effectiveness and safety of Shexiang Tongxin Dripping Pills combined with conventional treatment and conventional treatment alone. The experimental group was treated with She-xiang Tongxin Dropping Pills combined with conventional Western medicine treatment, while the control group was treated with conventional Western medicine treatment alone. The cost-utility analysis and sensitivity analysis were performed for the two regimens using Treeage pro. After 30 cycles of model simulation, according to the results of Markov model, the total cost and health output were CNY 237 795.73 and 16.36 QALYs(the quality adjusted life years, QALYs), respectively for Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment, CNY 247 396.55 and 16.36 QALYs respectively for the conventional Western medicine treatment alone. Compared with the conventional treatment alone, the Shexiang Tongxin Dropping Pills combined with conventional treatment had lower long-term cost and higher health output, with advantages of cost-utility and pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is considered that compared with the conventional Western medicine alone, Shexiang Tongxin Dropping Pill combined with conventional Western medicine is a treatment regimen with pharmacoeconomic advantages for the treatment of CHD.

Current situation and prospect of traditional Chinese medicine and western medicine in diagnosis and treatment of failed back surgery syndrome

As a common postoperative complication of lumbar diseases such as lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis, failed back surgery syndrome(FBSS) seriously affects the postoperative satisfaction of patients due to its difficulty in treatment and long course. At present, the treatment mainly involves comprehensive treatment of traditional Chinese medicine and western medicine, individualized treatment and stepwise therapy. The difficulty lies in how to accurately select the indications and timing of revision surgery, minimizing the damage the spinal stability, and effectively improving the symptoms. In the future, there will be a trend towards precision, minimally invasive, individualized and multidisciplinary therapies. Combined with literature review, the authors summarized the background of FBSS and the status of diagnosis as well as treatment of traditional Chinese medicine and western medicine, and looked forward to the future treatment direction, so as to provide certain reference for clinical treatment of this disease.