ObjectiveTo observe the clinical effect of combined traditional Chinese and Western medicine in the treatment of knee osteoarthritis (KOA). MethodsA total of 180 KOA patients treated between January 2012 and June 2015 were randomly assigned to 3 groups: Chinese medicine group (group A, n=60) with acupuncture and irradiation therapy of specific electromagnetic wave therapeutic apparatus , western medicine group (group B, n=60) with oral glucosamine hydrochloride tablets and knee joint cavity injection of sodium hyaluronate, and integrated traditional Chinese and Western medicine group (group C, n=60) with treatments combining those in both group A and B. The treatment course was 6 weeks. The Western Ontario & McMaster University (WOMAC) osteoarthritis index score and total effective rate were evaluated before treatment and 2 weeks after treatment, end of treatment and 5 months after treatment. ResultsAfter treatment, the average improvement of WOMAC scores in the three groups was significantly different (P ＜ 0.05) . The total effective rate was 78.33% in group A, 83.33% in group B, and 91.67% in group C. The difference of total effective rate between group C and A, and between group C and B was statistically significant (P＜0.05) ; and it was also statistically significant between group A and B (P ＜ 0.05) . There were two cases of adverse reactions in group A, two in group B, and two in group C, and the reactions were all relatively mild without any serious adverse events. ConclusionsChinese medicine and western medicine are both effective and safe for the treatment of KOA. When they are combined, the effect is further enhanced with no increase of adverse reactions.
Postoperative gastrointestinal disorder (POGD) is a common complication after surgery under anesthesia. Strategies in combination with traditional Chinese medicine and Western medicine have shown some distinct effects but standardized clinical practice guidelines are not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center /Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients’ preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations include disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
目的：对中药配合肝动脉栓塞化疗（Transcatheter Arterial Chemoembolization,TACE）辅助治疗原发性肝癌随机对照试验(Randomized controlled trial,RCT)文献进行评价。方法：对国内外公开发表的有关中药配合TACE辅助治疗原发性肝癌的随机对照试验进行检索，检索数据库包括Cochrane图书馆临床对照试验库，MEDLINE、CBM、CNKI和VIP电子数据库。手工检索中文相关期刊以及附加检索相关会议论文集。质量评价采用Jadad评分量表、CONSORT标准和其他自拟评价指标进行分析。结果：共纳入103篇RCTs，其中Jadad评分得5分有1篇文献，3分1篇，2分10篇，71篇1分，其余20篇均为0分，有3篇文献报告了分配隐藏。按CONSORT标准，仅1篇(0.97%)RCT描述了如何产生随机顺序，没有RCT报道如何执行随机，其中1篇为半随机，有1篇(0.97%)RCT采用安慰剂对照，有54篇(52.43%)报道了终点指标，分别各有2篇(1.94%)报道了双盲和单盲，14篇(1359%)进行了具体统计量计算，54篇(52.43%)提供了随访记录，7篇(6.80%)报道了阴性结果，16篇(15.53%)报道不良事件，仅有1篇(0.97%)进行样本含量计算与意向性分析(ITT),有2篇(1.94%)进行分层分析，属于多中心的仅有1篇(0.97%)，均未进行伦理审批和知情同意。描述了中医证型的有3篇(2.91%)。结论:目前中药配合TACE辅助治疗原发性肝癌临床研究的方法学和报告质量尚低，且多数RCT可能存在选择性偏倚和测量性偏倚，期待更多高质量的随机双盲对照试验为临床应用提供可靠的依据。
Objective To analyze the effectiveness of conservative medical treatments for ectopic pregnancy (EP): methotrexate (MTX) + mifepristone + Ectopic Pregnancy II decoction (EP-II) vs. methotrexate + mifepristone. Methods A total of 95 patients with EP in Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University from January 2009 to January 2011 were randomly divided into two groups: 45 patients in the experimental group were treated with MTX, mifepristone and EP II decoction, while the other 50 patients in the control group were treated with MTX and mifepristone. The effectiveness of the two groups was analyzed with SPSS 13.0 software. Results There were significant differences in the time of serum β-HCG return to normal (16.13±8.13 ds vs. 22.05±7.15 ds, Plt;0.05), time of EP mass absorption (30.46±7.56 ds vs. 39.99±18.26 ds, Plt;0.05) and tubal patency rate (80% vs. 75%, Plt;0.05) between the two groups. But there were no significant differences in effective rate (95.56%, 43/45 vs. 94%, 47/50, χ2=0.0809, Pgt;0.05) and side effects. Conclusion The combination of methotrexate, mifepristone and EP II decoction for ectopic pregnancy is more effective than mifepristone and methotrexate in coordinately killing the embryo, shortening the time of serum β-HCG return to normal and the time of EP mass absorption, and improving the function of oviducts.
ObjectiveTo compare the clinical effectiveness of Chinese medicine with that of integrated Chinese medicine and antimicrobial drugs in the treatment of pneumonia. MethodsThe electronic medical record (EMR) of patients with pneumonia who were admitted to the Classical Department of Chinese Medicine of Guangdong Hospital of Traditional Chinese Medicine from November 29, 2012 to June 17, 2022 were retrospectively collected. The patients were divided into two groups according to whether they were treated with antimicrobial drugs on the basis of Chinese medicine treatment. The non-exposed group was the traditional Chinese medicine group, and the exposed group was the integrated Chinese medicine and antimicrobial drugs group. Propensity score matching method was used to balance possible confounding factors. COX regression analysis was performed on the matched cohort to compare death rates among the groups, and Kaplan-Meier curve was drawn to evaluate the survival probability during hospitalization. The proportion of maximum oxygen concentration and duration of fever remission were compared between the two groups. ResultsThis study included a total of 898 cases, with the majority (over 95%) falling within the range of mild to moderate severity. After propensity score matching,180 patients remained in each group, among whom the baseline characteristics were comparable. The primary outcome indicators showed that the risk of death during hospitalization was same in the integrated Chinese medicine and antimicrobial drugs group and in the Chinese medicine group (HR=1.52, 95%CI 0.36 to 6.39, P=0.566), the subgroup analysis was consistent with the overall trend of the results, and the differences were not statistically significant. The results indicate that during the hospitalization, the overall and subgroup mortality rates were similar between the two groups. The treatment effectiveness on the disappearance of major symptoms such as fever, cough, sputum production, fatigue, shortness of breath, and chest pain were comparable in both groups. The secondary outcome indicators showed that there was no statistical significance in the comparison of the proportion of maximum oxygen therapy concentration and the stable duration of fever remission between the two groups. ConclusionIn the treatment of patients with mainly mild to moderate pneumonia, the effectiveness of the Chinese medicine group and the integrated Chinese medicine and antimicrobial drugs group in the hospitalization mortality, the disappearance of major symptoms, the proportion of maximum oxygen therapy concentration and the stable duration of fever remission are similar. Chinese medicine has a positive significance in reducing the use of antimicrobials in patients with pneumonia.
ObjectiveTo construct a prediction model of diabetics distal symmetric polyneuropathy (DSPN) based on neural network algorithm and the characteristic data of traditional Chinese medicine and Western medicine. MethodsFrom the inpatients with diabetes in the First Affiliated Hospital of Anhui University of Chinese Medicine from 2017 to 2022, 4 071 cases with complete data were selected. The early warning model of DSPN was established by using neural network, and 49 indicators including general epidemiological data, laboratory examination, signs and symptoms of traditional Chinese medicine were included to analyze the potential risk factors of DSPN, and the weight values of variable features were sorted. Validation was performed using ten-fold crossover, and the model was measured by accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC value. ResultsThe mean duration of diabetes in the DSPN group was about 4 years longer than that in the non-DSPN group (P<0.001). Compared with non-DSPN patients, DSPN patients had a significantly higher proportion of Chinese medicine symptoms and signs such as numbness of limb, limb pain, dizziness and palpitations, fatigue, thirst with desire to drink, dry mouth and throat, blurred vision, frequent urination, slow reaction, dull complexion, purple tongue, thready pulse and hesitant pulse (P<0.001). In this study, the DSPN neural network prediction model was established by integrating traditional Chinese and Western medicine feature data. The AUC of the model was 0.945 3, the accuracy was 87.68%, the sensitivity was 73.9%, the specificity was 92.7%, the positive predictive value was 78.7%, and the negative predictive value was 90.72%. ConclusionThe fusion of Chinese and Western medicine characteristic data has great clinical value for early diagnosis, and the established model has high accuracy and diagnostic efficacy, which can provide practical tools for DSPN screening and diagnosis in diabetic population.
Objective To compare the effectiveness of integrated traditional Chinese medicine (TCM) with Western medicine and Western medicine alone for acute episodes of withdrawal in alcoholism. Methods According to the criteria of alcohol dependence and acute alcochol withdrawal syndrome of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) , 62 consecutive patients were divided into two groups: 31 patients with odd numbers were allocated to the treatment group (4 patients were excluded because they left hospital early), 31 patients with even numbers were allocated to the control group. According to the four diagnostic methods of TCM, all patients in the treatment group were further divided into 4 types. The treatment group received valium, tiopronin, transfusion therapy and herbs (potion per day). The control group received the same therapy as the treatment group did but without oral herbs. Results Liver function, especially the difference between before and after treatment of GOT and γ-GT,the treatment group showed more improvement than the control group (P=0.046 and 0.001). The scores of anxiety and depression test, especially the HAMD, the treatment group showed more improvement than the control group (t=3.165, P=0.003). The treatment group used significantly less time than the control group (P=0.01), but no statistically significant difference was seen in the dosage of valium between the two groups (P=0.434). Conclusions The efficacy of integrated TCM with Western medicine is better than Western medicine alone for acute episodes of withdrawal in alcoholism.
Despite of the progress in the treatment of severe acute pancreatitis (SAP), there are still factors that hinder the improvement of the efficacy of treatment: there is a lack of an accurate and easy-to-use system for early severity prediction; the multidisciplinary collaboration mechanism needs to be further optimized; there is no clinical efficacy evaluation system for traditional Chinese medicine (TCM); the therapeutic targets of TCM are unclear; the effector substances are unknown; and the research and development of new medicines is still difficult. In order to further reduce the mortality of SAP and realize the goal of improving the efficacy, we should strengthen the integration of Chinese and Western medicine, multidisciplinary collaboration, and improve the treatment levels; as well as carry out basic and clinical research oriented to clinical value. We will also promote the innovative development of combined Chinese and Western medicine in the treatment of SAP by elucidating the mechanism, validating the efficacy and commercializing the achievements. In view of SAP, a major and difficult disease, we should insist on the principle of integrity and innovation, the synergy of Chinese and Western medicines and the complementarity of advantages, and promote the innovation and development of combined Chinese and Western medicines in the treatment of SAP, so as to further reduce the morbidity and mortality and to alleviate the burden of the disease.