Western Medicine Treatment Research Articles

Korean medicine doctors’ views on Western medicine and Korean medicine collaborative treatment in Korea: study protocol for a qualitative study

IntroductionRecently, there has been a growing interest in the collaboration between Western Medicine and Korean Medicine (WMKM) in Korea. Various research projects, including a national pilot project for WMKM collaborative treatment by the government, are being conducted. However, clinicians continue to face difficulties while conducting WMKM collaborative treatments in the clinical field. Therefore, it is necessary to consider the opinions of clinicians regarding the perceptions, experiences, barriers, and future improvement strategies using a qualitative approach. MethodsFocus group interviews will be conducted for 1) private hospitals, 2) national hospitals, and 3) university hospitals. Each focus group will consist of no more than six Korean Medicine doctors as the interviewees. A semi-standardized open-ended questionnaire will be used. Coding and analysis will be based on qualitative content analysis methods. Based on the questions, the codes, subcategories, and categories will be drawn. Member checks, triangulation, audit, and peer debriefing methods will be used for trustworthiness. ResultsThe qualitative analysis will address the following research questions: 1) What is the experience and perception of collaborative treatment including its advantages and disadvantages? 2) What are the barriers in a well-organized and effective collaborative treatment? and 3) What support policy is needed? DiscussionThis qualitative research will help overcome the limitations of previous studies and present new strategies for improvement in WMKM collaborative treatment. ConclusionThis protocol will enhance the trustworthiness of our research. Trial registrationClinical Research Information Service: KCT0003861

The clinical effect of plum blossom needle acupuncture with qi-invigorating superficies-consolidating therapy on seborrheic alopecia.

Seborrheic alopecia (SA) is a common dermatological disease with a long disease course, and treatment for this disease usually exhibits slow effects. Currently, Western medicine treatments have shown some effects; however, they also have certain limitations. In recent years, Chinese medicine has made breakthroughs in treating SA. The efficacy of plum blossom needle acupuncture with qi-invigorating superficies-consolidating therapy for SA was observed, and its clinical effects were investigated in this study. A total of 87 patients with SA treated at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2018 to September 2019 were enrolled as the research subjects. They were divided into a Western medicine group and a Chinese medicine group by the random number table method. The 43 patients in the Western medicine group were treated with conventional Western medicine, and the 44 patients in the Chinese medicine group were treated with a comprehensive traditional Chinese medicine regimen of plum blossom needling with qi-invigorating superficies-consolidating therapy. The treatment effects, changes in estradiol (E2) and testosterone (T) levels, and scores for various body signs (hair growth and hair loss) of the two groups before and after treatment were compared. The difference in total effective rate between the Chinese medicine group and the Western medicine group (95.45% vs. 81.40%) was statistically significant (P<0.05). After treatment, the T levels of both groups were lower than before treatment, and the E2 levels of both groups were higher than before treatment; the difference between the two groups was statistically significant (P<0.05). After treatment, the hair growth and hair loss scores of the two groups were lower than those before treatment, and those of the Chinese medicine group were lower than those of the Western medicine group; the differences were statistically significant (P<0.05). Plum blossom needle acupuncture combined with qi-invigorating superficies-consolidating therapy is significantly effective for treating patients with SA. It can effectively adjust the patient's hormone levels, improve hair loss, and promote hair growth. It has the advantages of simplicity, tolerability, and low cost. It cures the cause of the disease and is worth promoting.

Moxibustion for the treatment of ankylosing spondylitis: a systematic review and meta-analysis.

To systematically evaluate the efficacy of moxibustion in the treatment of ankylosing spondylitis (AS). Seven electronic databases were systematically searched for relevant studies for inclusion from databases inception to December 31, 2018. Randomized controlled trials investigating the efficacy of moxibustion for AS treatment versus Western medicine (Wm) treatment were included for systematic review and meta-analysis. Effect estimates were pooled using the fixed or random-effects models. Between-study heterogeneity and publication bias were also assessed. Stratification analyses were further performed based on the treatment plan of experimental groups. Twenty-six studies were eligible for inclusion with a total of 1,944 AS patients. Meta-analysis showed that compared with those receiving Wm treatment alone, patients receiving moxibustion combined with Wm treatment or moxibustion alone had a higher clinical efficacy rate [odds ratio (OR) =4.21, 95% confidence interval (CI): 2.91 to 6.10, P<0.001 for moxibustion combined with Wm versus Wm; OR =2.43, 95% CI: 1.62 to 3.65, P<0.001 for moxibustion alone versus Wm]. In addition, patients receiving moxibustion combined with Wm treatment had lower levels of C-reactive protein [weighed-median difference (WMD) =-6.33, 95% CI: -9.64 to -3.01, P<0.001] and erythrocyte sedimentation rate (WMD =-7.86, 95% CI: -11.26 to -4.46, P<0.001) after treatment, respectively. Furthermore, moxibustion could also improve Schober test scores (WMD =0.85, 95% CI: 0.15 to 1.55, P=0.017), occipital-wall distances (WMD =-0.55, 95% CI: -0.92 to -0.19, P=0.003), and finger-ground distances (WMD =-3.64, 95% CI: -5.61 to -1.68, P<0.001) of AS patients. This study suggests that moxibustion is an effective complementary treatment for AS patients. However, further large-scale multicenter clinical trials are needed to confirm these findings.

The clinical research on Bairui grain combined with ambroxol atomization inhalation treating acute attack patients of chronic bronchitis

Objective To observe the clinical effect of Bairui grain combined with ambroxol atomization inhalation treating acute attack of chronic bronchitis (wind heat attact the lung symptom). Methods A total of 150 patients with acute attack of chronic bronchitis who were admitted in our hospital from July 2015 to July 2018 were randomly divided into control and intervention groups (75 each group) by the random number table method. The control group received ambroxol atomization inhalatio based on the regular western medicine treatment; the intervention group took Bairui grain orally based on control group. Both of the two groups were treated for 2 weeks. Before and after the treatment, to score the clinical symptoms and wind-heat attact the lung symptom. Use pulmonary function meter to detect the ratio of FEV1 to estimated value (FEV1%) and FEV1/FVC; use ELISA to detect serum and sputum levels of TNF-α and IL-6. Record the extinction time of the symptoms (cough, wheezing, sputum, lung rumble) and evaluate the clinical efficacy. Results The total efficacy rate of intervention group was 98.6% (72/73), which was significantly higher than control group 88.9% (64/73) (χ2=4.354, P=0.037). The symptoms (cough, wheezing, sputum, lung rumble) extinction time of intervention group were significantly less than those of the control group (t values 5.331, 5.590, 5.841, 6.305, respectively, all Ps<0.01). After the treatment, scores of clinical symptoms (cough, wheeze, cough, cough) and symptoms of wind-heat attacking lung (cough, wheezing, fever, dry mouth, stuffy nose, runny nose) of intervention group were significantly lower than those of the control group (t values 4.990, 4.431, 5.221, 5.004, 5.652, 5.190, 5.311, 5.793, 5.643, respectively, all Ps<0.01). After treatment, the FEV1% (52.51% ± 5.63% vs. 47.30% ± 5.21%, t=8.931) and FEV1/FVC (61.57 ± 6.44 vs. 56.87 ±5.82, t=8.251) were significantly higher than the control group (P<0.01). The serum level of TNF-α, IL-6 (t values 5.331, 4.908) and the level of TNF-α, IL-6 (t values 6.001, 4.803) in sputum were significantly lower than those of the control group (P<0.01). Conclusions The Bairui grain combined with ambroxol atomization inhalation can decrease the inflammotory cytokine levels of the acute attack patients with chronic bronchitis (syndrome of wind-heat attacking lung symptome), improve clinical symptoms and enhance efficacy. Key words: Bronchitis, chronic; Bairui grain; Ambroxol; Nebulization inhalation therapy; Integrated Chinese traditional and western medicine therapy

Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews.

Background Migraine is a common neurological disease, which burdens individuals and society all over the world. Acupuncture, an important method in Traditional Chinese Medicine, is widely used in clinical practice as a treatment for migraine. Several systematic reviews (SRs) have investigated the effectiveness and safety of acupuncture for migraine. Objective To summarize and critically assess the quality of relevant SRs and present an objective and comprehensive evidence on the effectiveness and safety of acupuncture for migraine. Data Sources. MEDLINE, Embase, Cochrane Library, PROSPERO database, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), China Science and Technology Journal (SCTJ), and WanFang database (WF) were searched from inception to December 2019 and grey literatures were manually searched. Selection Criteria. SRs which meet the criteria were independently selected by 2 reviewers according to a predetermined protocol. Data Extraction. Characteristics of included SRs were independently extracted by 2 reviewers following a predefined data extraction form. Review Appraisal. The methodological quality, risk of bias, and reporting quality of included SRs were assessed, respectively, by a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis-Acupuncture (PRISMA-A) statement. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results A total of 15 SRs were included. All the SRs were published between 2011–2019. Based on AMSTAR 2, 14 out of 15 SRs were rated critically low quality and 1 was rated low quality. According to ROBIS tool, 9 SRs (60%) were low risk of bias. With the PRISMA-A checklist, we found 11 out of 15 SRs were found adequately reported over 70%. With the GRADE tool, we found high quality of evidence indicated that the effective rate of acupuncture was superior to western medicine in treatment of migraine. Besides, acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture. Limitations. There might be some missing information. The accuracy of the conclusions may be decreased reduced since we were unable to synthesis all the evidence. Conclusions Based on high quality of evidence, we concluded that acupuncture may be an effective and safe therapy for migraine. However, the quality of SRs in acupuncture for migraine still needs more improvement.

Transcutaneous electrical acupoint stimulation for early enteral nutrition tolerance in patients with sepsis of gastrointestinal dysfunction: a multi-center randomized controlled trial

To compare the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) combined with conventional western medicine and western medicine alone on early enteral nutrition tolerance in patients with sepsis. Forty-nine patients with sepsis were randomly divided into an observation group (24 cases) and a control group (25 cases). The control group was treated with conventional western medicine, including limited fluid resuscitation, anti-infection and maintenance of hemodynamics, and enteral nutrition was provided when the hemodynamics became stable and the dosage of vasoactive drugs was reduced. The observation group, on the basis of the treatment of the control group, was treated with TEAS at Tianshu (ST 25), Shangjuxu (ST 37), Jiexi (ST 41), Diji (SP 8), Zusanli (ST 36), Zhongwan (CV 12) and Daheng (SP 15) when the enteral nutrition was provided (dilatational wave, 2 Hz/10 Hz, twice a day, 30 min each time), and the TEAS stopped when enteral nutrition was normal. The antral motility index (MI) was evaluated by ultrasonography on the first, third and fifth day into treatment in the two groups, and the duration from providing enteral nutrition to normal enteral nutrition was recorded. The acute gastrointestinal injury (AGI) classification, admission time of intensive care unit (ICU) and hospitalization time were compared. The antral MI on the third and fifth day into treatment in the observation group was significantly higher than that in the control group (P<0.05). The duration from providing enteral nutrition to normal enteral nutrition was (5.08±0.65) days in the observation group, which was shorter than (5.56±0.65) days in the control group (P<0.05). The improvement of AGI classification after treatment in the observation group was significantly superior to the control group (P<0.05). The hospitalization time in the observation group was shorter than that in the control group (P<0.05). TEAS combined with conventional western medicine treatment could significantly promote gastrointestinal peristalsis, improve the early intestinal nutrition tolerance in patients with sepsis, so as to shorten the time of reaching the standard of enteral nutrition and hospitalization time, which is better than conventional western medicine treatment alone.

A randomized controlled trial for prevention of acute exacerbation of stable chronic obstructive pulmonary disease with acupoint application of traditional Chinese medicine: Study protocol clinical trial (SPIRIT Compliant).

Introduction:Chronic obstructive pulmonary disease (COPD) is a major public health problem that severely affects the quality of life of patients and may even endanger their lives. Although modern medicine has achieved significant results in relieving the clinical manifestations of COPD, it is difficult to prevent its progression and acute exacerbation entirely. As one of the classic aspects of acupuncture and moxibustion therapy, acupoint application of traditional Chinese medicine (TCM) can improve the clinical efficacy of western medicine in treating COPD. To date, however,there is no high-quality clinical trial to assess the effectiveness of TCM acupoint application directly in preventing acute exacerbation of stable COPD.Methods:The study is a randomized, double-blind, placebo-controlled trial, in which 200 stable COPD patients will be randomly and equally divided into the experimental group or control group. Both groups will undergo standard Western medicine treatment; however, the patients in the experimental group will be also treated with TCM acupoint application, while the control group will be given placebo acupoint application. The duration of the treatment will be 1 month and a follow-up for 11 months. The primary outcome will be the number of acute exacerbation episodes of COPD, and the secondary outcomes will include the lung function, St George's Respiratory Questionnaire, COPD Assessment Test, and 6-Minute Walk Test. A safety assessment will also be performed during the trial.Discussion:The aim of this study is to evaluate the efficacy and safety of TCM acupoint application in preventing acute exacerbation of stable COPD. Our study will provide sound evidence to support the evidence-based medicine of TCM acupoint application as an additional measure in the prevention of acute exacerbation of stable COPD.Trial registration:ChiCTR1900026564, Registered 14 October, 2019

Current Research Trends in Randomized Controlled Trials Investigating the Combined Effect of Korean Medicine and Western Medicine Treatment

This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (&lt;i&gt;n&lt;/i&gt; = 47; 51%), and 19% (&lt;i&gt;n&lt;/i&gt; = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (&lt;i&gt;n&lt;/i&gt; = 16; 17%), and mental and behavioral disorders (&lt;i&gt;n&lt;/i&gt; = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.

Acupuncture for cognitive impairment in vascular dementia, Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis

IntroductionCognitive impairment is a worldwide health problem. Numerous studies have been conducted to evaluate the effect of acupuncture on cognitive impairment. However, it is still unclear that if acupuncture shows the same efficacy on cognitive impairment caused by different diseases. Therefore, we conducted a systematic review and meta-analysis based on the current evidence to evaluate the efficacy and safety of acupuncture for cognitive impairment in vascular dementia (VD), Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients. MethodsFive databases were searched from their inception to December 2019. Randomized controlled trials (RCTs) involving VD, AD or MCI treated by acupuncture alone or as part of combination therapy were included. The primary outcomes were the Mini-Mental State Examination and the Hierarchic Dementia Scale. ResultsTwenty-one RCTs (N = 2253) were quantitatively analyzed. For VD, compared with Western medicine (WM), acupuncture showed better Hierarchic Dementia Scale scores (P < 0.01), and acupuncture plus WM also showed better Hierarchic Dementia Scale scores (P < 0.01). For MCI, acupuncture showed a significant improvement in Mini-Mental State Examination (P < 0.01) and picture recognition test scores compared with WM. For AD, WM resulted in better Hierarchic Dementia Scale scores than acupuncture (P < 0.01). Eight trials reported adverse events, 15 out of 2253 patients had adverse events related to acupuncture treatment, and 25 out of 2253 patients had adverse events related to WM treatment. ConclusionAcupuncture may be efficacious for improving cognitive function in patients with VD and MCI. However, the evidence is limited, and larger sample size and more rigorous RCTs should be conducted to verify the effectiveness and safety of acupuncture.

Traditional Chinese medicine for ulcerative colitis: systematic reviews based on PRIO-harms

This article is aimed to reevaluate the systematic reviews(Meta-analysis) of traditional Chinese medicine in the treatment of ulcerative colitis, and provide reference for evidence-based decision-making of traditional Chinese medicine(TCM). According to the preferred reporting items for overviews(preferred reporting items for overview of systematic reviews, PRIO-harms), the main Chinese and English electronic literature databases(PubMed, Cochrane Library, EMbase, CNKI, CBM, etc.) were retrieved, supplemented by manual retrieval. Systematic reviews for the treatment of ulcerative colitis with Chinese medicine up to February 2019 were included. Two researchers independently performed literature screening and data extraction. The methodology quality, reporting quality and evidence quality of the literature were evaluated by AMSTAR 2 tool, PRISMA scale and GRADE system respectively. Subgroup analysis was performed by using RevMan 5.3 software. A total of 21 systematic reviews were included, and the interventions mainly included TCM internal and external treatment, with 53 outcome indicators. The AMSTAR 2 results showed that 5 articles were of high quality, 9 of medium quality, 4 of low quality, and 3 of extremely low quality. The most problematic items were as follows: the list of excluded documents was not provided; the sources of funding for each study were not reported; and the research methods were not determined before implementation. PRISMA scale had an average score of(20.38±1.43) points, less than 22 points for 15 articles, with certain reporting defects. The GRADE system suggested that the quality of the evidence for the 30 outcome indicators was low or very low. The most important factors leading to degrading was the limitation, followed by publication bias and inconsistency. The results showed that as compared with conventional Western medicine, TCM oral or enema treatment for mild to moderate ulcerative colitis had better clinical efficacy and safety. Due to the quality limitations of the included studies, it is necessary to further strengthen the top-level design and follow the scientific research paradigm to provide a higher level of evidence for the clinical evidence-based decision-making of TCM.

Pay attention to the early recognition of severe digestive system infection and the treatment of integrated traditional Chinese and western medicine

Digestive tract is one of the biggest contact surfaces between human body and environmental factors. It has a large number of microorganisms from the environment. Once bacteria transfer and release into the blood, it will cause sepsis and endanger life. Therefore, we should pay more attention to the infectious diseases of digestive system. This paper reviews six articles published in this journal, and expounds the etiology and early recognition methods of severity of three common infectious diseases of acute digestive system, namely, acute diarrhea, acute cholangitis and acute pancreatitis, and puts forward potential targets for the treatment of sepsis from the perspective of neurohumoral and integrated traditional Chinese and western medicine. Therefore, we should pay attention to the early recognition of the severity of infectious diseases of digestive system and the treatment of integrated traditional Chinese and western medicine. Key words: Digestive system; Infection; Severity of illness; Early diagnosis; TCM WM THERAPY

Intestinal dysfunction of spinal cord injury treated with tongdu tiaoshen moxibustion: a randomized controlled trial

To compare the clinical effect on intestinal dysfunction of spinal cord injury (SCI) between the comprehensive therapy of tongdu tiaoshen moxibustion (moxibustion for opening the governor vessel and regulating the spirit) and rehabilitation training and the simple treatment with rehabilitation training. A total of 60 patients with intestinal dysfunction of SCI were randomized into a comprehensive therapy group and a rehabilitation group, 30 cases in each one (3 cases were dropped out in each group). On the base of the routine western medicine treatment and rehabilitation training, the bowel training and rectal function training were provided, once a day in the rehabilitation group. In the comprehensive therapy group, on the base of the treatment as the rehabilitation group, the tongdu tiaoshen moxibustion was exerted at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Dazhui (GV 14) and Baihui (GV 20), etc, once a day, 30 min each time. In both groups, the treatment for 4 weeks was as one course and 3 courses of treatment were required. Separately, before treatment, after 4, 8 and 12 weeks of treatment, the scores of neurogenic bowel dysfunction (NBD) and World Health Organization quality of life scale (WHOQOL-BREF) were observed and the clinical effect was evaluated after 12 weeks of treatment. After treatment, the total effective rate was 88.9% (24/27) in the comprehensive therapy group, which was higher than 74.1% (20/27) in the rehabilitation group (P<0.05). After 4, 8 and 12 weeks of treatment, NBD scores were all reduced obviously as compared with those before treatment in the two groups (all P<0.01). After 8 and 12 weeks of treatment, NBD scores in the comprehensive therapy group were lower than the rehabilitation group (both P<0.05). After 4, 8 and 12 weeks of treatment, the scores of all of the domains (psychology, physiology, social relations and environment) in WHOQOL-BREF were higher than those before treatment in the two groups (all P<0.01). After 4 weeks of treatment, the scores in the psychology and physiology domains in the comprehensive therapy group were higher than the rehabilitation group (all P<0.05). After 8 and 12 weeks of treatment, the scores of all of the domains in the comprehensive therapy group were higher than the rehabilitation group (all P<0.05). The comprehensive treatment of tongdu tiaoshen moxibustion and rehabilitation training achieves the better effect on intestinal dysfunction of SCI than the simple rehabilitation training and greatly improves the quality of life in SCI patients.

Effect of Tongqiao Huoxue Decoction Combined with Western Medicine on Ischemic Stroke: A Systematic Review.

Objective We conducted a systematic review and meta-analysis to systematically evaluate the curative effect of Tongqiao Huoxue Decoction (TQHXD) combined with Western medicine treatment (WMT) on Ischemic Stroke (IS). Methods Randomized controlled trials (RCTs) of TQHXD in the treatment of IS by computer retrieval of PubMed, Embase, Web of Science, Chinese Biomedical Literature Service System, CNKI, Wanfang Database, and Weipu Database. The retrieval time was taken from the establishment of the database to July 30, 2020. Two researchers, respectively, conducted a strict evaluation of the quality of the literature and extracted the data which were then entered in the RevMan5.3 software for meta-analysis. Results 40 articles were listed, which involved 3260 patients. Meta-analysis results show that TQHXD combined with WMT can significantly reduce patients' NIHSS score, serum hypersensitivity C-reactive protein (hs-CRP), plasma viscosity, serum fibrinogen, serum total cholesterol, and serum triglycerides and improve patients' ADL-Barthel scoring and treatment efficiency. However, there is no evidence that TQHXD combined with the WMT group can significantly decrease the incidence of adverse events. Conclusion The therapeutic effect of TQHXD combined with the WMT group was significantly better than that of the WMT alone group. For the treatment of patients with IS, TQHXD combined with WMT is worthy of application and promotion.

Effects and Relative Factors of Adjunctive Chinese Medicine Therapy on Survival of Hepatocellular Carcinoma Patients: A Retrospective Cohort Study in Taiwan.

Some patients with cancer use adjunctive Chinese medicine, which might improve the quality of life. This study aims to investigate the effects and relative factors of adjunctive Chinese medicine on survival of hepatocellular carcinoma patients at different stages. The study population was 23 581 newly diagnosed hepatocellular carcinoma patients and received surgery from 2004 to 2010 in Taiwan. After propensity score matching with a ratio of 1:10, this study included 1339 hepatocellular carcinoma patients who used adjunctive Chinese medicine and 13 390 hepatocellular carcinoma patients who used only Western medicine treatment. All patients were observed until the end of 2012. Kaplan-Meier method and Cox proportional hazards model was applied to find the relative risk of death between these 2 groups. The study results show that the relative risk of death was lower for patients with adjunctive Chinese medicine treatment than patients with only Western medicine treatment (hazard ratio = 0.68; 95% confidence interval = 0.62-0.74). The survival rates of patients with adjunctive Chinese medicine or Western medicine treatment were as follows: 1-year survival rate: 83% versus 72%; 3-year survival rate: 53% versus 44%; and 5-year survival rate: 40% versus 31%. The factors associated with survival of hepatocellular carcinoma patients included treatment, demographic characteristics, cancer stage, health status, physician characteristics, and characteristics of primary medical institution. Moreover, stage I and stage II hepatocellular carcinoma patients had better survival outcome than stage III patients by using adjunctive Chinese medicine therapy. The effect of adjunctive Chinese medicine was better on early-stage disease.

Could Xuebijing Injection Reduce the Mortality of Severe Pneumonia Patients? A Systematic Review and Meta-Analysis.

Methods Databases including PubMed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP were searched, from inception to February 2020, to identify randomized controlled trials (RCTs) about XBJ combined with western medicine treatment in treating severe pneumonia. Literature screening, data extraction, and methodological quality assessment were carried out by two researchers back-to-back. RevMan 5.3 software was used for statistical analysis. Results A total of 21 articles involving 2072 patients were included. The meta-analysis showed that treatment combined with XBJ has better efficiency compared with western medicine treatment alone. It could also decrease 28-day mortality; shorten the length of intensive care unit (ICU) stay time and mechanical ventilation time; and reduce the levels of C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and D-dimer in the serum of patients. The incidence of adverse reactions did not increase significantly. Conclusion XBJ combined with western medicine treatment has significant clinical efficacy and no obvious adverse reactions. A dose of 100 ml bid is recommended to reduce 28-day mortality. The conclusion needs to be further verified with larger-sample size and higher-quality RCTs.

Clinical diagnosis and integrated treatment of traditional Chinese and western medicine for confirmed patients with coronavirus disease 2019 in Yangzhou area of Jiangsu Province

Objective To summarize and evaluate the epidemiological characteristics, clinical symptoms, laboratory tests, treatment options and prognosis of novel coronavirus pneumonia(Coronavirus Disease 2019, COVID-19)in Yangzhou. Methods The clinical data of 23 COVID-19 hospitalized patients in Yangzhou Infectious Disease Hospital were collected and analyzed. Results (1) Case characteristics: nucleic acid tests(oropharyngeal swabs)were positive in 23 patients, including 1 severe case and 22 common cases, aged 23 to 72 years, with 10 males and 13 females. There were 21 cases(91.3%)with contact history, among which familial clustering occurred in 7 cases. The average incubation period was 5 days. (2) Clinical symptoms mainly included cough, fever(78.3%), followed by sputum symptoms(26.1%), chest tightness and asthma(26.1%), and digestive tract symptoms(8.7%). (3) Hematological examination: the total number of white blood cells was normal, with low lymphocytes occurring in 16 patients, abnormal liver function in two patients at admission; - triglycerides and cholesterol increased, and C reactive protein(CRP)decreased at discharge. (4) Imaging examinations: CT scan of the chest showed that multiple ground glass shadows was seen under the pleura, complicating with interstitial thickening. (5) Treatments: all the patients were treated by antiviral, anti-infective, and oxygen inhalation treatments. Only one severe patient was given non-invasive ventilation. All patients were discharged after negative results of the nucleic acid test. Conclusions Positive nucleic acid test and multiple ground-glass shadows complicating with interstitial thickening by chest CT are important evidence for diagnosis of novel coronary pneumonia, and contact history of susceptible people, cough as well as fever symptoms, and low lymphocytes are important clinical manifestations of novel coronavirus pneumonia. In clinic, comprehensive treatment of Chinese and western medicine is an effective treatment for COVID-19.

Clinical evaluation on xiyanping injection in the treatment of bronchopneumonia in children based on meta-analysis

Objective: The aim of this study is to evaluate the effectiveness and safety of xiyanping injection (XYPI) in the treatment of children with bronchopneumonia. Methods: A systematic and comprehensive search was conducted in the domestic and foreign electronic databases CNKI, SinoMed, VIP, WanFang DATA, PubMed, The Cochrane Library, Embase, Web of Science, Clinical-Trials.gov, and the search date ended on May 30, 2019. Inclusion criteria: (1) the types of studies included were randomized controlled trials; (2) the study participants were infants and children with a clear diagnosis of bronchopneumonia, without gender and ethnic restrictions; (3) the intervention test group was XYPI or the control group plus XYPI. The control group was routine treatment (RT) (basic treatment such as fever, cough and asthma, oxygen inhalation, anti-infection, maintaining water, electrolyte balance, etc.) or other Western medicine or RT + other Western medicine treatment. Except for XYPI, the two groups were consistent in intervention measures. According to the Cochrane Handbook, 5.1 evaluation standard and a meta-analysis of the final included studies was performed using RevMan 5.3 software. Results: A total of 57 studies were included, with a total sample size of 8454 cases, of which 4255 were in the experimental group and 4199 were in the control group. Meta-analysis results showed that (1) Total effective rate: XYPI group was better than the control group (relative risk [RRRT] = 1.25, 95% confidence interval [CI] [1.15, 1.36], P

The Efficacy and Safety of Integrated Chinese Plus Western Medicine Compared with Western Medicine Alone in the Treatment for Purpuric Nephritis: A Meta-Aalysis

Objective: This research is aimed to systematically evaluate the efficacy and safety of Chinese plus Western Medicine treatment for Childhood purpuric nephritis by Meta-analysis, in order to improve the cure rate and reduce adverse reactions of this disease, then provide guidance for clinical medication. Methods: There are six major databases including CNKI, Pubmed, Embase, World Wide Database, Web of science and Science Direct retrieved through the Internet, and the randomized-controlled trials of the combined therapy for Childhood purpuric nephritis published both in Chinese and English from the 1999 to October 2019 were collected. Meta-analysis by R software 3.5.0 was adopted to analyze the effective index and adverse effect. Results: In total 92 papers of randomized-controlled clinical studies were enrolled. HSPN children treated with combined therapy demonstrated a significant increase in total effective rate (RR=1.19; 95%CI (1.16–1.21), P<0.001) when compared with Western medicine alone. Our study also found that Chinese plus Western medicine had an advantage on decreasing 24-hour urine protein (WMD=-0.47; 95%CI (-0.53,-0.41); p<0.001) and urine erythrocyte count (WMD=-8.88; 95%CI (-9.80,-7.96); p<0.001) when compared with Western medicine. Children seemed to benefit more from combined treatment in the adverse effect (RR=0.64; 95%CI (0.46, 0.87); p<0.01). Conclusions: Integrated Chinese plus Western medicine treatment was effective for Childhood purpuric nephritis, which may be a superior alternative for HSPN. Nevertheless, long-term, high-quality and multicenter RCTs are required to make the results more convincing.

Analysis of TCM Syndrome Types of Manic Disorder: Data from Clinical Therapy of TCM and Western Medicine

Objective: to analyze the distribution characteristics and composition ratio of Chinese medicine syndrome in manic disease from the published literature on the combined treatment of manic mania by Chinese and Western medicine. Methods: to collect literature from Chinese database, to analyze and classify the cases that meet the standard combined treatment of Chinese and Western medicine, analyze the distribution of different syndromes and composition ratio. Results: 1385 cases were studied. Among them, 48.95% were phlegm fire disturbance to the mind, 20.50% were stagnation of phlegm and heat, 12.37% were liver and gall depression heat, 10.76% were qi stagnation and blood stasis, and 7.51% were fire injury Yin. Conclusion: The first three syndrome can cover more than 80% of the proportion. The contribution degree of the first three is also higher.

Efficacy and Safety of Bushenjiangya-Optimized Granule for Left Ventricular Diastolic Dysfunction in Hypertensive Patients: A Double-Blind, Randomized, Placebo-Controlled Trial.

Objective The study aimed to evaluate the efficacy and safety of Bushenjiangya-optimized (BSJYO) granule on left ventricular diastolic dysfunction (LVDD) in hypertensive (HTN) patients. Methods 120 patients diagnosed with HTN plus LVDD were randomly assigned to the BSJYO granule group and placebo group, and all patients received basal western medicine (WM) treatment. After eight weeks of treatment, we evaluated echocardiography, traditional Chinese medicine (TCM) syndromes, 24-hour ambulatory blood pressure, liver and kidney functions, and adverse events. Major adverse cardiovascular events (MACEs) were collected at 6-month follow-up. Results Compared with pretreatment, E/Ea (Doppler-derived index of filling pressure and worsening LVDD) significantly decreased significantly after 8 weeks of treatment in the BSJYO granule plus basal WM group (10.52 ± 1.87 vs. 9.49 ± 1.49, P < 0.01), alongside reductions in significantly effective response (SER), effective response (ER), and total effective response (TER = SER + ER) in TCM symptom scores (21.59% vs. 71.70%, P < 0.01). There were no differences between treatment groups in kidney and liver function, early adverse events, or MACE. Conclusion BSJYO granule plus basal WM is an effective and safe therapy for HTN patients with LVDD.