Advanced Chinese Medicine最新文献

Primary cutaneous CD30 positive anaplastic large cell lymphoma (PC-ALCL) is a rare non-Hodgkin's lymphoma. Combined chemotherapy regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin), or F-MACHOP (5-fluorouracil, methotrexate, cytosine-arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone) are often used for its clinical treatment. In this study, we reported a new treatment method using a traditional Chinese therapy involving oral Wenyang Shengji decoction (WSD) combined with Huanglian ointment applied externally in a 32-year-old female patient with PC-ALCL. Introduction: A 32-year-old woman who complained of an ulcer on the forehead accompanied by significant pain. PC-ALCL was diagnosed by histopathological examination and immunohistochemical analysis. Treatment plan: WSD was prepared in 300 mL water and administered orally as a 150 mL decoction twice daily, and Huanglian ointment was applied to the ulcer three times daily. After 8 weeks of treatment with WSD combined with Huanglian ointment, the lesion healed completely. Immunohistochemical analysis revealed the presence of scattered CD3+++, CD4++, CD8++, CD20++, and CD30-positive cells. After 12 weeks of treatment, the ulcer healed completely, leaving only a marked pale red-pitted scar. The patient was followed up for 3 years without recurrence and no adverse events. Conclusion: oral WSD combined with Huanglian ointment applied to the ulcer for PC-ALCL can promote the healing of ulcers, reduce or alleviate the formation of scar, and eliminate CD30-positive cells. This case report provides a reference for the clinical treatment of PC-ALCL using traditional Chinese medicine.

Objective

To evaluate the advancements in cardiopulmonary exercise testing (CPET) among overweight or obese patients.

Methods

Reviewed the recent studies on clinical trials of CPET in overweight and obese patients, thought about the CPET advantage in obesity, while CPET equipment use for elucidating the principles underlying obesity and using CPET kinematic scheme to explore fat metabolism.

Results

The exercise program developed by CPET is scientific, sustainable and advantageous. With this trial, we can develop a relatively effective, fast and measurable amount of exercise, on the basis of the exercise test in obese people, CPET can provide scientific and digital motion reducing weight for overweight patients. At the same time, the trial has become widely applied in research into drug and surgical treatments for overweight patients. It is possible to quantify the efficacy of a trial and ultimately assess the merits of CPET.

Conclusion

CPET is considered as a fundamental criterion for designing motion schemes. Despite limitations of equipment errors and patient endurance, the benefits of CPET in program formulation have been gradually recognized, which made it a promising tool in the field of obesity management.

Background

Diabetic kidney disease (DKD) is one of the most common microvascular complications of diabetes mellitus and has become the primary cause of end-stage renal disease in China. In patients with severe renal insufficiency, Western medical treatments often yield unsatisfactory results. Preliminary studies have indicated that the Chinese herbal formula Tangshen Fang improves estimated glomerular filtration rate (eGFR) in patients with DKD.

Methods/design

This is a multicenter, randomized, open-label, controlled clinical trial. DKD patients with eGFR levels between 25 and 75 mL/min (1.73 m²) and urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g, or eGFR level between 25 and 60 mL/min (1.73 m²) and UACR <30 mg will be included. A total of 144 participants will be randomly allocated to the treatment group (Tangshen Fang plus standard Western medicine with or without other traditional Chinese medicine [TCM]) and the control group (standard Western medicine with or without other TCM) at a 1:1 ration. The study duration will be 24 weeks and the follow-up period will be extended to 96 weeks. The primary endpoint will be the change in eGFR from baseline to week 24. Secondary endpoints will include changes in UACR, body weight, waist circumference, blood pressure, lipid levels, fasting plasma glucose, glycosylated hemoglobin A₁c (HbA₁c), and improvement in TCM symptoms and quality of life. Adverse events will also be evaluated.

Discussion

This study will provide evidence of the effectiveness and safety of Tangshen Fang in treating patients with DKD. It will also form the clinical pathway and expert consensus on integrating traditional Chinese and Western medicine for DKD and provide clinical evidence for the rational use of hospital preparations of Tangshen Fang.

Trial registration

Chinese Clinical Trials Registry, ChiCTR2300069269. Registered March 10, 2023.

Objective

This study intends to investigate the medication patterns of traditional Chinese medicine (TCM) for the treatment of acute cardiorenal syndrome (ACRS) through clinical data mining.

Methods

A retrospective study was conducted at China-Japan Friendship Hospital, encompassing hospitalized patients with ACSR admitted from June 1, 2013, to June 30, 2022. Patient treatment records, including TCM prescriptions, were gathered to establish a comprehensive prescription database. The prescriptions underwent analysis using the ancient and modern medical case cloud platform, incorporating the frequency, properties and flavors and channel tropism of each herbs, and clustering patterns, combination relationships, and complex network analysis of the whole.

Results

A total of 330 prescriptions from eligible hospitalized patients were included, which totally involves 324 kinds of different herbs. The therapeutic effects primarily emphasized descending qi and eliminating turbidity, promoting diuresis and reducing swelling, drying dampness and dispelling phlegm, and promoting the ascension of Yang Qi. The properties were largely warm, netural, slightly cool and cold, with warm being predominant. The flavors were chiefly sweet, spicy, and bitter, with sweetness being the most common. The major channel tropism were the lung and spleen meridians, followed by the stomach, liver, heart, and kidney meridians. Combination analysis identified 30 pairs of combinations, with higher associations found in combinations such as Jiegeng, Huangqi, Chaihu, Baizhu, Zhimu, and Dangshen. Cluster analysis categorized high-frequency herbs into 4 groups: Gualou–Fabanxia–Chuanxiong–Chishao, Fuling–Baizhu–Zhigancao–Chenpi, Maidong–Guizhi–Huangqi–Chaihu–Shengma–Zhimu–Shanzhuyu, and Huangqi–Dangshen–Jiegeng–Chaihu–Shengma–Zhimu–Shanzhuyu. Complex network analysis revealed core prescriptions for treating ACRS, including 17 herbs.

Conclusions

In the treatment of ACRS, TCM herbs with the properties of warm and neturality, and the flavors of sweet and spicy are commonly utilized. The prescribed herbal formulas have the effect of descending qi and eliminating turbidity, tonifying qi, activating blood and resolving stasis, resolving phlegm and promoting water.