Traditional Chinese medicine (TCM) has unique advantages in treating diabetic osteoporosis (DOP). This study aimed to explore the mechanisms underlying the protective effects of herb couplet medicines (Erxian) on DOP using network pharmacology and verify these mechanisms using cell experiments.
We used chromatography to analyze the bioactive components of serum containing Erxian couplet medicines (ECMs) and searched for possible targets of the active ingredients in the Traditional Chinese Medicine Systems Pharmacology database. The target proteins of DOP were retrieved from the GeneCards and Online Mendelian Inheritance in Man databases. A component-target network diagram was then constructed using the screened drug components and target information for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. In vitro, cell morphological changes were observed using alkaline phosphatase staining, and the effect of the ECMs on osteoblast viability was assessed using a cell counting kit-8 assay. Finally, the pathway information predicted by network pharmacology was validated using flow cytometry, real-time polymerase chain reaction, and western blot experiments.
Twelve types of active ingredients in serum containing ECMs were obtained via chromatography, and 96 potential targets were identified using network pharmacology analysis. Furthermore, GO and KEGG pathway enrichment analyses revealed that the ECMs might participate in the apoptosis signaling pathway in the treatment of DOP. In vitro tests showed that treatment with ECM serum increased osteoblasts’ survival rate and improved the HG group's cell morphology (P < 0.05). BCL2-associated X protein (BAX) expression increased in the HG group but decreased after ECM serum addition (P < 0.05). The expression of B-cell lymphoma-2 (BCL-2) was found to be reduced in the HG group but increased after ECM serum addition (P < 0.05).
ECMs can treat DOP via multiple targets and multiple signaling pathways. Moreover, the mechanism underlying the effects of ECMs on osteoblasts was verified by inhibiting apoptotic. The complete signaling pathway requires future study.
Naturopathy is a well-known and utilised form of traditional, complementary, and integrative medicine (TCIM). Limited New Zealand research exists that has examined the utilisation of naturopathy from the perspective of users. The present study was designed to identify and explore individual's experiences and perceptions of naturopathic care.
Twenty clients (18 female and two male) who attended a student naturopathy and herbal medicine teaching clinic in Auckland, New Zealand were individually interviewed via Zoom video conferencing using open-ended questions. Interview transcripts were anlysed using an inductive thematic approach, focusing on similarities in participants' experiences and perceptions of their naturopathic treatment.
Six main themes were identified regarding individual's experiences and perceptions of naturopathic care (1) feeling heard, (2) perceived attributes of the student practitioner and feeling looked after, (3) perceived knowledge of student practitioners, (4) high degree of client education, (5) partnership, empowerment and ownership, and (6) recommending naturopathy based on own experiences.
Participants reported positive experiences and perceptions of their naturopathic treatment. Participants felt heard and looked after and indicated that their student naturopaths were caring, supportive and knowledgeable. Client education enhanced health literacy and participants felt empowered and in control of their health and healing. Client education was perceived to be important for individuals with chronic health conditions, as the information imparted was not always covered by their other healthcare practitioners.
Whether traditional East Asian medicine (TEAM) is compatible with biomedicine remains controversial, with biomedicine research failing to explain key TEAM concepts. This article hypothesizes that reconciliation could be effective if biomedicine assumed that it examines a limited portion of reality, whereas Eastern medicine aims to conceptualize reality in its entirety. Re-discovering elements of Western thought that allow epistemological expansion, such as the notion of a non-material aspect inherent to all phenomena, and its implications for research methodology, can encourage biomedical research to reflect on TEAM.
The article reviews sources from the Western and Eastern medical literature to explore the above hypothesis.
The concept of Qi (氣), inherent in TEAM's interpretive framework, lays the foundations for theoretical compatibility and a practical integrative approach. In TEAM, Qi is the basic fabric from which all things are made; however, holding that all things have a non-material aspect is also deeply rooted in the European religious and philosophical tradition. This article proposes that biomedicine detects the denser part of the Qi spectrum conceived by TEAM. As an illness progresses, parts of Qi that make up the organism become increasingly separated, but biomedicine detects disharmony only when the magnitude reaches a certain level owing to its sensitivity range.
Both TEAM and biomedicine consider the patient's complaint as an unquestionable reality that medicine can observe and aims to alleviate. TEAM assumes that traditions distilled over millennia require verification through evidence-based medicine to gain credibility in the West, which owes its success to its skeptical attitude. Meanwhile, biomedicine assumes that some mechanisms that influence health and healing may not be measurable by current biomedical devices. However, this does not mean that these mechanisms cannot be verified, albeit with an emphasis on patients’ subjective experiences. The theoretical compatibility of TEAM and biomedicine creates sufficient legitimacy for their co-existence, and research on their sequential, rather than alternative or complementary, use in healthcare is needed.
Dry eye disease (DED) has become increasingly prevalent in ophthalmology, significantly impacting patients' quality of life. Despite the widespread use of acupuncture therapies in treating DED, the most effective acupuncture treatment strategy remains uncertain. This study aimed to provide guidance in clinical practice for selecting the most effective acupuncture treatment strategy using the network meta-analysis (NMA) method.
Seven English and Chinese databases were searched from their inception to October 15, 2023, to collect randomized controlled trials (RCTs) related to acupuncture therapies for treating DED. The risk of bias was assessed using the revised Cochrane risk of bias tool (ROB 2.0). Network meta-analysis was conducted using R 4.1.2 and Stata 17.0. The Confidence in Network Meta-Analysis (CINeMA) tool was used to evaluate the certainty of evidence.
A total of 41 studies with 2931 participants were included. The network meta-analysis results showed that conventional acupuncture combined with thumbtack needle had the best efficacy in improving tear break-up time (TBUT) (MD = 2.95, 95 % CI [1.49, 4.39]) and Schirmer's test (MD = 3.34, 95 % CI [0.90, 5.79]). In terms of improving the corneal fluorescein staining score, conventional acupuncture combined with electroacupuncture demonstrated the best efficacy (SMD = -0.80, 95 % CI [-1.40, -0.18]). The confidence ratings of different treatment comparisons were judged as very low to low. Eight studies reported adverse effects, none of which were serious.
The NMA results support the use of acupuncture for treating DED. Among the therapies, conventional acupuncture combined with thumbtack needle and conventional acupuncture combined with electroacupuncture have higher priority. However, before widespread adoption, more multicenter, randomized, double-blind, and placebo-controlled clinical trials are needed to confirm these findings.
Infantile cerebral palsy (ICP) is a disease that causes cognitive and motor dysfunction in children, severely affecting their growth and mental health. Infantile tuina is a prominent treatment modality in traditional Chinese medicine (TCM). However, the effectiveness of infantile tuina remains uncertain. This systematic review aimed to assess the efficacy of infantile tuina in enhancing motor dysfunction in ICP through randomized controlled trials (RCTs).
We completed the meta-analysis according to the PRISMA 2020 checklist. Randomized controlled trials (RCTs) were searched for in seven databases including Medline, Ovid EMBASE, Cochrane Library, Web of Science, China national knowledge infrastructure, Chinese biomedical literature, and Wan Fang from the establishment of the database until November 7, 2023. The effectiveness of infantile tuina to treat motor dysfunction in children with spastic cerebral palsy was evaluated using outcome indexes such as effective rate, Gross motor function measure (GMFM), Modified Ashworth Scale (MAS), and ankle passive dorsiflexion angle.
A total of 12 RCTs were included in this systematic review, which included 950 patients. Meta-analysis of the results indicated that infantile tuina combined with conventional rehabilitation treatment for ICP produced better results than conventional rehabilitation treatment alone. The experimental group intervention had a significant effect on the improvement of ICP treatment efficiency [Relative Risk (RR) = 1.21; 95% Confidence Interval (CI) = 1.10, 1.33], GMFM [MD = 4.76, 95% CI = 3.23, 3.29], MAS [Mean difference (MD) = -0.83, 95% CI = -1.02, -0.64], and ankle dorsiflexion angle [MD = -4.82, 95% CI = -7.45, -2.18]. The results were statistically significant (P < 0.05).
As a complementary therapy to conventional rehabilitation therapy, infantile tuina produced significant improvements in ICP treatment effectiveness in this systematic review. The main limitation in the evidence was a lack of high-quality studies and many studies had small sample sizes.
PROSPERO ID: CRD42023446889.
This study aimed to identify the target of action of Wendan decoction, a classical Chinese herbal formula used for the treatment of psychiatric disorders, specifically schizophrenia, using network pharmacology.
Traditional Chinese Medicine (TCM) bioinformatics and network pharmacology were employed to predict the genes regulated by miR-26b-5p and identify the active ingredients and related targets of the Wendan decoction from public databases. Key components and targets were screened by constructing a "TCM-component-target" network, followed by pathway enrichment analysis of the related targets. The expression levels of miR-26b-5p and prostaglandin-endoperoxide synthase 2 (PTGS2) in the peripheral blood of patients with schizophrenia patients and healthy individuals were determined using RT-qPCR. Molecular docking was performed to explore the interaction between the active ingredients of the Wendan decoction and key differentially expressed molecules, investigating the role of miR-26b-5p in the treatment of schizophrenia with the Wendan decoction.
A total of 135 active constituents were extracted from the Wendan decoction, and 144 molecules, including PTGS2 and other derivatives, were screened for drug-target and disease-target inter-mapping. Compared to peripheral blood samples from healthy controls and patients with depression, peripheral blood samples from patients with schizophrenia patients showed low miR-26b-5p expression and elevated PTGS2 expression, with no significant difference observed in the expression between healthy controls and patients with depression. Molecular docking revealed that several active compounds were found in five of the six constituents of the Wendan decoction bound with PTGS2. Pathway enrichment analysis suggested that the Wendan decoction may have a potential therapeutic role in treating schizophrenia by regulating the circadian rhythm, N-methyl-d-aspartate glutamate receptor activity, inflammatory mediator regulation of transient receptor potential channels, and other pathways implicated in schizophrenia.
Wendan decoction may treat schizophrenia via the miR-26b-5p targeting factor PTGS2 and inflammation-related pathways. miR-26b-5p, combined with PTSG2, holds the potential as a differential diagnostic marker for schizophrenia.