Integrative Medicine Research最新文献_第8页

Misreport of burns as a result of ‘coining’, Gua sha; inherent harms from publication and ongoing citation of false facts 误报因“造币”造成烧伤，瓜沙;发表和持续引用虚假事实的内在危害

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-06-01 DOI: 10.1016/j.imr.2023.100953

Arya Nielsen , Marsha Handel , Jennifer  A.  M. Stone , Myeong  Soo Lee

引用次数: 1

Comparative effectiveness of Chinese herbal injections treating for rotavirus enteritis in children: A systematic review and Bayesian network meta-analysis 中药注射剂治疗小儿轮状病毒肠炎的比较疗效:系统评价和贝叶斯网络荟萃分析

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-06-01 DOI: 10.1016/j.imr.2023.100944

Li-Qing Niu , Lu Xiao , Qiu-Han Cai , Yu-Yi Wu , Si-Yuan Hu , Sheng-Xuan Guo , Yu-Ling Tian , Qiu-Rong Wang

Background

Rotavirus enteritis (RVE) accounts for 37% of all death in children (<5 years) with diarrhea. Chinese herbal injections (CHIs) have drawn more attention from practitioners because of the valid effects for RVE. However, the most beneficial one has not yet been determined.

Methods

Eight databases were searched from their inception up to September 3, 2022. The primary outcome was clinical effective rate and the secondary outcomes were time for disappearance of diarrhea, time of defervescence, time for disappearance of vomiting, and adverse drug reactions or adverse drug events. OpenBUGS 3.2.3 and STATA 14.0 software were employed to carry out the NMA.

Results

58 randomized controlled trials (RCTs) with 6436 child patients were included in this Bayesian NMA. Four CHIs were investigated including Yanhuning injection (YHN), Xiyanping injection (XYP), Reduning injection (RDN), and Zedoary Turmeric Oil injection (ZTO). The results showed that YHN [OR=6.16, 95% CI (4.39, 8.77)] had a superior effect in improving clinical effective rate compared to Ribavirin based on Western medicine (WM). According to SUCRA values, YHN (84.1%) ranked highest. As for the secondary outcomes, XYP was the better intervention in shortening the time for disappearance of diarrhea. Regarding time for defervescence, RDN had obvious advantages and also performed well in time for disappearance of vomiting.

Conclusions

CHIs combined with WM could be beneficial than Ribavirin in improving clinical effective rate, and YHN was the optimum treatment. From the comprehensive evaluations of both the clinical effective rate and other outcomes, YHN also indicated a favorable therapeutic effect in RVE.

Study registration

This study was registered on PROSPERO (CRD42022357149).

背景轮状病毒肠炎（RVE）占腹泻儿童（＜5岁）全部死亡的37%。中药注射剂因其对RVE的有效治疗作用而越来越受到从业者的关注。然而，最有益的一个尚未确定。方法检索8个数据库，从创建到2022年9月3日。主要结果是临床有效率，次要结果是腹泻消失时间、退热时间、呕吐消失时间以及药物不良反应或药物不良事件。采用OpenBUGS 3.2.3和STATA 14.0软件进行NMA。结果本贝叶斯NMA包括58项随机对照试验（RCT），涉及6436名儿童患者。研究了炎琥宁注射液（YHN）、喜炎平注射液（XYP）、热丁宁注射液（RDN）和莪术油注射液（ZTO）四种CHI。结果表明，YHN[OR=6.16，95%CI（4.39，8.77）]在提高临床有效率方面优于基于西药的利巴韦林。根据SUCRA值，YHN（84.1%）排名最高。至于次要结果，XYP是缩短腹泻消失时间的较好干预措施。在退腾时间方面，RDN具有明显的优势，在呕吐消失的时间方面也表现良好。结论中西医结合治疗有效率明显高于利巴韦林，YHN是最佳治疗方法。从临床有效率和其他结果的综合评估来看，YHN在RVE中也显示出良好的治疗效果。研究注册本研究已在PROSPERO（CRD42022357149）上注册。

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引用次数: 0

Attenuation of skeletal muscle atrophy via acupuncture, electro-acupuncture, and electrical stimulation 针刺、电针和电刺激对骨骼肌萎缩的抑制作用

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-06-01 DOI: 10.1016/j.imr.2023.100949

T. Brock Symons , Jinho Park , Joo Hyun Kim , Eun Hye Kwon , Jesse Delacruz , Junghoon Lee , Yoonjung Park , Eunhee Chung , Sukho Lee

Background

Accelerated skeletal muscle wasting is a shared trait among many pathologies and aging. Acupuncture has been used as a therapeutic intervention to control pain; however, little is known about its effects on skeletal muscle atrophy and function. The study's purpose was to compare the effects of acupuncture, electro-acupuncture, and electrical stimulation on cast-induced skeletal muscle atrophy.

Methods

Forty female Sprague Dawley rats were randomly divided into groups: Control, casted (CAST), CAST+Acupuncture (CAST-A), 4) CAST+Electro-acupuncture (CAST-EA), and CAST+Electrical stimulation (CAST-ES) (n = 8). Plaster casting material was wrapped around the left hind limb. Acupuncture and electro-acupuncture (10 Hz, 6.4 mA) treatments were applied by needling acupoints (stomach-36 and gallbladder-34). Electrical stimulation (10 Hz, 6.4 mA) was conducted by needling the lateral and medial gastrocnemius muscles. Treatments were conducted for 15 min, three times/week for 14 days. Muscle atrophy F-box (MAFbx), muscle RING finger 1 (MuRF1), and contractile properties were assessed.

Results

Fourteen days of cast-immobilization decreased muscle fiber CSA by 56% in the CAST group (p = 0.00); whereas, all treatment groups demonstrated greater muscle fiber CSA than the CAST group (p = 0.00). Cast-immobilization increased MAFbx and MuRF1 protein expression in the CAST group (p<0.01) while the CAST-A, CAST-EA, and CAST-ES groups demonstrated lower levels of MAFbx and MuRF1 protein expression (p<0.02) compared to the CAST group. Following fourteen days of cast-immobilization, peak twitch tension did not differ between the CAST-A and CON groups (p = 0.12).

Conclusion

Skeletal muscle atrophy, induced by 14 days of cast-immobilization, was significantly attenuated by acupuncture, electro-acupuncture, or electrical stimulation.

背景骨骼肌萎缩加速是多种疾病和衰老的共同特征。针灸已被用作控制疼痛的治疗干预措施；然而，人们对其对骨骼肌萎缩和功能的影响知之甚少。本研究的目的是比较针灸、电针和电刺激对石膏诱导的骨骼肌萎缩的影响。方法雌性Sprague-Dawley大鼠40只，随机分为对照组、铸态组（CAST）、铸态+针刺组（CAST-A）、铸极+电针组（CAST-EA）和铸态+电刺激组（CAST-ES）（n=8）。石膏浇注材料包裹在左后肢上。针刺穴位（胃36和胆囊34），采用针刺和电针（10Hz，6.4mA）治疗。通过针刺腓肠肌外侧和内侧进行电刺激（10Hz，6.4mA）。治疗时间为15分钟，每周3次，持续14天。评估肌肉萎缩F-box（MAFbx）、肌肉环指1（MuRF1）和收缩特性。结果固定14天后，cast组的肌纤维CSA降低了56%（p=0.00）；然而，所有治疗组都表现出比CAST组更大的肌纤维CSA（p＝0.00）。与CAST组相比，CAST组的固定化增加了MAFbx和MuRF1蛋白表达（p＜0.01），而CAST-A、CAST-EA和CAST-ES组的MAFbx及MuRF1蛋白质表达水平较低（p＜0.02）。石膏固定14天后，cast-A组和CON组的峰值抽搐张力没有差异（p=0.012）。结论针刺、电针或电刺激可显著减轻石膏固定14天引起的骨骼肌萎缩。

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引用次数: 2

World Health Organization survey on the level of integration of traditional Chinese medicine in Chinese health system rehabilitation services 世界卫生组织关于中医药在中国卫生系统康复服务中的整合水平的调查

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-06-01 DOI: 10.1016/j.imr.2023.100945

Lei Fang , Ran-ran Zhu , Zhen Sang , Xiao-ting Xu , Lin-yun Zheng , Yanwei Xiang , Chaoyang Guo , Zhenrui Li , Stéphane Alexandre Espinosa , Qi Zhang , Chunlei Shan

Background

To meet the growing global demand for rehabilitation services, the World Health Organization (WHO) launched Rehabilitation 2030. This study was commissioned by the WHO to investigate the integration degree of traditional Chinese medicine (TCM) in Chinese health system rehabilitation services and the demand for TCM rehabilitation in China.

Methods

Twenty TCM rehabilitation experts and relevant government administrators were invited to complete the questionnaire between September 2019 and January 2022. The development of traditional, complementary, and integrative medicine (TCI) rehabilitation in China was assessed primarily based on six different health system components.

Results

26 policies, regulations, and national strategic plans related to TCI rehabilitation were issued by relevant government departments since 2002; notably, 14 policies related to TCI rehabilitation development were intensively introduced from 2016 to 2021. These policies cover the three main areas of financing, infrastructure development, and service delivery. The National Administration of Traditional Chinese Medicine's investment in TCM clinical capacity infrastructure and scientific research in 2019–2021 increased by 66% compared to 2010–2012, and the average number of TCM hospitals with rehabilitation departments in 2020 increased by 6.5% compared to 2018. The proportion of community health service centers providing TCM services in primary medical and health institutions has increased by 30.8% over the past 10 years.

Conclusion

Long-term continuous policies, substantial financial investment, and expansion of the scope of TCI rehabilitation services in primary care institutions have effectively contributed to the rapid development of TCI rehabilitation. However, human resources and financing mechanisms for TCI rehabilitation need further improvement.

背景为了满足全球日益增长的康复服务需求，世界卫生组织（世界卫生组织）启动了“2030年康复”。本研究受世界卫生组织委托，旨在调查中医药在中国卫生系统康复服务中的整合程度和中国中医药康复需求。主要根据六个不同的卫生系统组成部分评估了中国传统、补充和综合医学康复的发展情况。结果2002年以来，政府相关部门颁布了26项TCI康复相关政策、法规和国家战略规划；值得注意的是，2016年至2021年，14项与TCI康复发展相关的政策密集出台。这些政策涵盖融资、基础设施发展和服务提供三个主要领域。国家中医药管理局2019-2021年在中医临床能力基础设施和科研方面的投资比2010-2012年增长了66%，2020年设有康复科的中医医院平均数量比2018年增长了6.5%。10年来，社区卫生服务中心在基层医疗卫生机构提供中医药服务的比例增长了30.8%。结论长期持续的政策、大量的财政投入以及基层医疗机构TCI康复服务范围的扩大，有效地促进了TCI康复的快速发展。然而，TCI康复的人力资源和筹资机制需要进一步改进。

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引用次数: 1

Effect and mechanism of Magnolia officinalis pharmacopuncture for treating localized fat via network pharmacology and experimental study 厚朴药孔治疗局部脂肪的作用机制及网络药理学与实验研究

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-06-01 DOI: 10.1016/j.imr.2023.100948

Won Jun Choi , Mi Hye Kim , Nayoung Park, Jae Yoon Chung, Sang Jun Park, Woong Mo Yang

Background

Recently, for various reasons, the need for non-invasive treatment for localized fat has emerged. This study confirmed whether Magnolia officinalis (MO) pharmacopuncture reduces localized fat by promoting lipolysis and inhibiting adipogenesis.

Methods

The network was built using genes related to the active compound of MO and the mode of action of MO was predicted by the functional enrichment analysis. Based on the result from network analysis, 100 µL of 2 mg/mL MO pharmacopuncture was injected into the inguinal fat pad for 6 weeks in obese C57BL/6J mice. Normal saline was injected into the right-side inguinal fat pad as a self-control.

Results

It was expected that the AMP-activated protein kinase (AMPK) signaling pathway would be affected by the MO Network. MO pharmacopuncture reduced the weight and size of inguinal fat in HFD-induced obese mice. The phosphorylation of AMPK along with the increases of lipases was significantly increased by MO injection. Also, the expression levels of fatty acid synthesize-related mediators were suppressed by MO injection.

Conclusion

Our results demonstrated that MO pharmacopuncture promoted the expression of AMPK, which has beneficial effects on activation of lipolysis and inhibition of lipogenesis. Pharmacopuncture of MO can be a non-surgical alternative therapy in the treatment of local fat tissue.

背景近年来，由于各种原因，出现了对局限性脂肪进行无创治疗的需求。本研究证实厚朴（MO）是否通过促进脂解和抑制脂肪生成来减少局部脂肪。方法利用MO活性化合物相关基因构建网络，通过功能富集分析预测MO的作用方式。根据网络分析结果，在肥胖C57BL/6J小鼠的腹股沟脂肪垫中注射100µL 2 mg/mL MO药效针6周。结果MO网络可能会影响AMPK信号通路。MO药效针刺降低了HFD诱导的肥胖小鼠腹股沟脂肪的重量和大小。注射MO后，AMPK的磷酸化作用随脂肪酶的增加而显著增加。此外，MO注射抑制了脂肪酸合成相关介质的表达水平。结论MO药物能促进AMPK的表达，对激活脂解和抑制脂肪生成具有有益作用。MO的药物穿刺可以作为治疗局部脂肪组织的非手术替代疗法。

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引用次数: 0

The effects of herbal medicine (Jujadokseo-hwan) on quality of life in patients with mild cognitive impairment: Cost-effectiveness analysis alongside randomized controlled trial 草药(Jujadokseo-hwan)对轻度认知障碍患者生活质量的影响:随机对照试验的成本效益分析

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-03-01 DOI: 10.1016/j.imr.2022.100914

Ji-Eun Lee , Hyung Won Kang , Sun-A Jung , So-Young Lee , Ju Yeon Kim , Da Eun Lee , Jin-Hyung Jeong , In Chul Jung , Eun Cho

Background

Mild cognitive impairment (MCI), the early stage of dementia, requires effective intervention for symptom management and improving patients’ quality of life (QoL). Jujadokseo-hwan (JDH) is a Korean herbal medicine prescription used to improve MCI symptoms, such as memory deficit. This study evaluates the improvement in QoL through JDH. Alongside a clinical trial, it estimates the cost-effectiveness of JDH, compared to placebo, for MCI over 24 weeks.

Methods

Changes in QoL were measured using the EuroQol-5 Dimensions (EQ-5D) and Korean version QoL-Alzheimer's Disease (KQOL-AD). Direct medical and non-medical costs were surveyed and incremental cost-effectiveness ratios (ICER) per QALY for JDH were produced.

Results

In total, 64 patients were included in the economic evaluation (n = 35 in JDH, n = 29 in placebo). In the JDH group, EQ-5D and KQOL-AD improved by 0.020 (p = .318) and 3.40 (p = .011) over 24 weeks, respectively. In the placebo group, they increased by 0.001 (p=.920) and 1.07 (p=.130), respectively. The ICER was KRW 76,400,000 per QALY and KRW 108,000 per KQOL-AD for JDH, compared to the placebo group.

Conclusion

JDH is not considered a cost-effective treatment option compared with placebo; however, it positively affects QoL improvement in patients with MCI.

背景轻度认知障碍(mild cognitive impairment, MCI)是早期痴呆，需要有效的干预来控制症状，提高患者的生活质量(QoL)。九加寿焕(JDH)是一种用于改善记忆障碍等轻度认知障碍症状的韩国草药处方。本研究通过JDH评估生活质量的改善。除了一项临床试验外，它还估计了与安慰剂相比，JDH在24周内治疗轻度认知损伤的成本效益。方法采用欧洲生活质量-5量表(EQ-5D)和韩版生活质量-阿尔茨海默病量表(KQOL-AD)测定生活质量的变化。调查了直接医疗费用和非医疗费用，并得出了JDH每个质量质量的增量成本效益比。结果共纳入64例患者进行经济评价(JDH组35例，安慰剂组29例)。在JDH组，EQ-5D和KQOL-AD在24周内分别提高了0.020 (p = .318)和3.40 (p = .011)。在安慰剂组，它们分别增加了0.001 (p= 0.920)和1.07 (p= 0.130)。与安慰剂组相比，JDH的ICER为每QALY 76,400,000韩元，每KQOL-AD 108,000韩元。结论与安慰剂相比，jdh不被认为是一种具有成本效益的治疗选择;然而，它对轻度认知障碍患者生活质量的改善有积极的影响。

{"title":"The effects of herbal medicine (Jujadokseo-hwan) on quality of life in patients with mild cognitive impairment: Cost-effectiveness analysis alongside randomized controlled trial","authors":"Ji-Eun Lee , Hyung Won Kang , Sun-A Jung , So-Young Lee , Ju Yeon Kim , Da Eun Lee , Jin-Hyung Jeong , In Chul Jung , Eun Cho","doi":"10.1016/j.imr.2022.100914","DOIUrl":"10.1016/j.imr.2022.100914","url":null,"abstract":"<div><h3>Background</h3><p>Mild cognitive impairment (MCI), the early stage of dementia, requires effective intervention for symptom management and improving patients’ quality of life (QoL). Jujadokseo-hwan (JDH) is a Korean herbal medicine prescription used to improve MCI symptoms, such as memory deficit. This study evaluates the improvement in QoL through JDH. Alongside a clinical trial, it estimates the cost-effectiveness of JDH, compared to placebo, for MCI over 24 weeks.</p></div><div><h3>Methods</h3><p>Changes in QoL were measured using the EuroQol-5 Dimensions (EQ-5D) and Korean version QoL-Alzheimer's Disease (KQOL-AD). Direct medical and non-medical costs were surveyed and incremental cost-effectiveness ratios (ICER) per QALY for JDH were produced.</p></div><div><h3>Results</h3><p>In total, 64 patients were included in the economic evaluation (n = 35 in JDH, n = 29 in placebo). In the JDH group, EQ-5D and KQOL-AD improved by 0.020 (p = .318) and 3.40 (p = .011) over 24 weeks, respectively. In the placebo group, they increased by 0.001 (p=.920) and 1.07 (p=.130), respectively. The ICER was KRW 76,400,000 per QALY and KRW 108,000 per KQOL-AD for JDH, compared to the placebo group.</p></div><div><h3>Conclusion</h3><p>JDH is not considered a cost-effective treatment option compared with placebo; however, it positively affects QoL improvement in patients with MCI.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/eb/main.PMC9826841.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10525184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complementary and alternative medicine mention and recommendations in pancreatic cancer clinical practice guidelines: A systematic review and quality assessment 胰腺癌临床实践指南中补充和替代医学的提及和建议:系统回顾和质量评估

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-03-01 DOI: 10.1016/j.imr.2023.100921

Jeremy Y Ng, Hardil Anup Bhatt, Maheen Raja

Background

Pancreatic cancer is the third leading cause of cancer death in the United States, which is attributed to limited treatment options. Complementary and alternative medicine (CAM) therapies have been proposed to provide benefits in treating pancreatic cancer. Despite its importance in treatment, clinicians are not generally well equipped to counsel their patients about CAM therapies. This review identified the quantity and assessed the quality of clinical practice guidelines (CPGs) providing CAM recommendations for the treatment and/or management of pancreatic cancer.

Methods

A systematic review was conducted to identify pancreatic cancer CPGs. MEDLINE, EMBASE and CINAHL were searched from 2011 to 2022. The Guidelines International Network (GIN) and the National Center for Complementary and Integrative Health (NCCIH) websites were also searched. Eligible CPGs published by non-profit agencies on treatment and/or management of pancreatic cancer for adults were assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument.

Results

From 31 eligible search results, 7 CPGs mentioned CAM and 3 CPGs made CAM recommendations. The mean scaled domain percentages of the CPGs in this study (overall, CAM-specific) were as follows: scope and purpose (81.3%, 77.8%), stakeholder involvement (63.9%, 42.6%), rigor-of-development (51.0%, 40.3%), clarity-of-presentation (83.3%, 54.6%), applicability (42.3%, 30.5%), and editorial independence (58.3%, 58.3%).

Conclusions

Evaluation of the CPGs demonstrated that quality varied both within and between CPGs. CPGs that scored well could be used by patients and clinicians as the basis for discussion for the use of CAM therapies. Future research should identify other appropriate CAM therapies for further development of CPGs for pancreatic cancer.

Registration

The protocol was registered on PROSPERO (registration number: CRD42022334025).

背景癌症是美国癌症死亡的第三大原因，这归因于有限的治疗选择。补充和替代医学（CAM）疗法已被提出在治疗癌症方面提供益处。尽管CAM在治疗中很重要，但临床医生通常不具备为患者提供CAM治疗建议的能力。这篇综述确定了临床实践指南（CPG）的数量并评估了其质量，该指南为癌症的治疗和/或管理提供了CAM建议。方法采用系统回顾的方法，对癌症患者的cpg进行鉴定。检索2011年至2022年MEDLINE、EMBASE和CINAHL。指南国际网络（GIN）和国家补充与综合健康中心（NCCIH）网站也被搜索。非营利机构发布的关于成人癌症治疗和/或管理的合格CPG使用指南、研究和评估II（AGREE II）工具进行评估。结果在31个符合条件的搜索结果中，有7个CPG提到CAM，3个CPG提出CAM推荐。本研究中CPG的平均标度域百分比（总体而言，CAM特定）如下：范围和目的（81.3%，77.8%）、利益相关者参与（63.9%，42.6%）、开发的严谨性（51.0%，40.3%）、呈现的清晰性（83.3%，54.6%）、适用性（42.3%，30.5%），和编辑独立性（58.3%，58.3%）。结论对CPG的评估表明，CPG内部和之间的质量各不相同。得分良好的CPG可以被患者和临床医生用作讨论CAM疗法使用的基础。未来的研究应确定其他合适的CAM疗法，以进一步开发用于癌症的CPG。注册该协议已在PROSPERO上注册（注册号：CRD42022334025）。

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引用次数: 2

Use of antibiotics and other treatments in Chinese adults with acute cough: An online survey 中国成人急性咳嗽抗生素和其他治疗的使用情况:一项在线调查

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-03-01 DOI: 10.1016/j.imr.2022.100920

Xiao-Yang Hu , Ru-Yu Xia , Michael Moore , Beth Stuart , Ling-Zi Wen , Bertrand Graz , Lily Lai , Jian-Ping Liu , Yu-Tong Fei , Merlin Willcox

Background

Acute respiratory tract infections are common worldwide and there has been a rapid increase in antibiotic consumption. This study aimed to identify use of various treatments and their association with the use of antibiotics and patient reported clinical recovery in Chinese adults with acute cough.

Methods

An online survey recruiting people who had recently experienced cough was conducted. Their sociodemographic, clinical characteristics, treatments received and their perceived changes in symptoms were collected. Factors influencing avoidance of antibiotics and improvement in symptoms were explored.

Results

A total of 22,787 adults with recent acute cough completed the questionnaire, covering all 34 province-level administrative units in China. Most respondents were male (68.0%), young (89.4%, aged 18–45), educated to university/degree or postgraduate level (44.6%), with a median cough severity of 6/10 on a numerical rating scale. Nearly half of the participants (46.4%) reported using antibiotics, among which 93.1% were for presumed upper respiratory tract infections (URTIs). Pharmacies (48.8%) were the most common source of antibiotics. Fewer patients took antibiotics after taking CHM (14.9%), compared to those who started with home remedies (18.0%), or allopathic non-antibiotic medication (25.0%). Antibiotics, allopathic non-antibiotic medications, CHM and home remedies were all perceived beneficial in relieving cough.

Conclusions

Chinese adult responders report use of a considerable variety of treatments alone or in combination for acute cough. Patient-reported clinical recovery was similar regardless of treatment. There is likely a high proportion of inappropriate use of antibiotics for treatment of simple acute cough. As the majority of respondents did not use antibiotics as a first-line, and use of CHM was associated with relief of cough symptoms and reduction in the use of antibiotics, this presents an important opportunity for prudent antibiotic stewardship in China.

背景急性呼吸道感染在世界范围内很常见，而且抗生素的消费量迅速增加。本研究旨在确定中国成人急性咳嗽的各种治疗方法的使用及其与抗生素使用的关系以及患者报告的临床康复情况。方法对近期有咳嗽症状的人群进行在线调查。收集他们的社会人口统计学、临床特征、接受的治疗以及他们感知到的症状变化。探讨了影响避免使用抗生素和改善症状的因素。结果共有22787名近期急性咳嗽的成年人完成了问卷调查，覆盖了全国34个省级行政单位。大多数受访者是男性（68.0%）、年轻人（89.4%，18-45岁）、受过大学/学位或研究生教育的人（44.6%），在数字评分表上，咳嗽严重程度的中位数为6/10。近一半的参与者（46.4%）报告使用了抗生素，其中93.1%用于推测的上呼吸道感染（URTI）。药店（48.8%）是最常见的抗生素来源。与那些开始服用家庭药物（18.0%）或对抗性非抗生素药物（25.0%）的患者相比，服用CHM后服用抗生素的患者更少（14.9%）。抗生素、对抗性非抗菌药物、CHM和家庭药物都被认为对止咳有益。结论中国成人应答者报告说，急性咳嗽单独或联合使用了相当多的治疗方法。患者报告的临床恢复情况与治疗无关。在治疗单纯急性咳嗽时，抗生素的不当使用比例可能很高。由于大多数受访者没有将抗生素作为一线使用，CHM的使用与咳嗽症状的缓解和抗生素使用的减少有关，这为中国谨慎管理抗生素提供了一个重要机会。

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引用次数: 0

Chinese herbal medicine for drug-induced liver injury in patients with HIV/AIDS: A systematic review of randomized controlled trials 中药治疗HIV/AIDS药物性肝损伤:随机对照试验的系统回顾

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-03-01 DOI: 10.1016/j.imr.2022.100918

Xiao-wen Zhang , Jing Li , Wen-bin Hou , Yue Jiang , Ruo-xiang Zheng , De-hao Xu , Chen Shen , Nicola Robinson , Jian-ping Liu

Background

To explore the effectiveness and safety of Chinese herbal medicine (CHM) for drug-induced liver injury (DILI) in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).

Methods

A systematic search was made of eight databases (Pubmed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, Sinomed) and two trial registries (WHO ICTRP, ClinicalTrials.gov) from inception to September 2022. The effect size was presented as risk ratio (RR) or mean difference (MD) with their 95% confidence interval (CI). The Cochrane Risk of Bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tools were used for quality appraisal.

Results

Ten randomized controlled trials (RCTs) involving 732 participants were included. Comparing CHM alone with routine treatment, the CHM group showed lower aspartate aminotransferase (MD=-11.47 U/L, 95%CI[-13.05, -9.89], low certainty), lower alanine aminotransferase (MD=-2.68 U/L, 95%CI[-4.27, -1.08], low certainty), lower total bilirubin (MD=-4.31 mmol/L, 95%CI[-5.66, -2.96], low certainty), lower bilirubin direct (MD=-3.19 mmol/L, 95%CI[-3.87, -2.51], low certainty), and higher effective rate (assessed by symptoms and liver indicators) (RR=1.13, 95%CI[1.06, 1.20], low certainty). A significant difference was also found in CHM plus routine treatment versus routine treatment in the previous outcomes. No significant difference was found on helper T cells among these comparisons. Only one RCT reported safety of CHM and found no adverse reaction during the trial.

Conclusions

CHM may improve the liver function indices and effective rate for HIV/AIDS patients with DILI. However, the sample size was small and quality was low. Larger-samples of high-quality trials are needed.

背景探讨中药治疗人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）药物性肝损伤（DILI）的有效性和安全性。方法从成立到2022年9月，系统检索8个数据库（Pubmed、Cochrane Library、Web of Science、Embase、CNKI、Wanfang、VIP、Sinomed）和2个试验注册中心（世界卫生组织ICTRP，ClinicalTrials.gov）。影响大小以风险比（RR）或平均差（MD）及其95%置信区间（CI）表示。使用Cochrane偏倚风险和建议、评估、发展和评价分级（GRADE）工具进行质量评估。结果纳入10项随机对照试验，共732名参与者。将CHM单独治疗与常规治疗进行比较，CHM组表现出较低的天冬氨酸转氨酶（MD=-11.47 U/L，95%CI[13.05，-9.89]，低确定性）、较低的丙氨酸转氨酶（MD=2.68 U/L，95%CI[4.27，-1.08]，低确定性）、低的总胆红素（MD=-4.31 mmol/L，95%CI[5.66，-2.96]，低确定度）、低直接胆红素（MD=3.19 mmol/L，95%CI[3.87，-2.51]，低确定性），和更高的有效率（通过症状和肝脏指标评估）（RR=1.13，95%CI[1.06，1.20]，低确定性）。CHM加常规治疗与常规治疗在先前的结果中也存在显著差异。在这些比较中，辅助性T细胞没有发现显著差异。只有一项随机对照试验报告了CHM的安全性，试验期间未发现不良反应。结论sCHM可改善艾滋病病毒/艾滋病DILI患者的肝功能指标和有效率。然而，样本量小，质量低。需要更大的高质量试验样本。

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引用次数: 0

Reporting quality of economic evaluations of the negotiated Traditional Chinese Medicines in national reimbursement drug list of China: A systematic review 中国国家报销药品目录谈判中药经济评价报告质量的系统评价

IF 3.4 4区医学 Q1 Medicine

Integrative Medicine Research

Pub Date : 2023-03-01 DOI: 10.1016/j.imr.2022.100915

Juntao Yan , Shiyi Bao , Liu Liu , Yu-Qing Zhang , Jian Ming , Yan Wei , Yingyao Chen

Background

Traditional Medicine (TM) has a wide uptake in most countries. In China, Traditional Chinese Medicine (TCM) is a common kind of primary health because of its beneficial effects. This review aimed to appraise the publication reporting quality of economic evaluations for selective TCM in the National Reimbursement Drug List (NRDL), Version 2020, based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

Methods

Electronic databases were searched for economic evaluation that supported the TCM negotiations in NRDL (2020 version) published from 2001 to 2021, including PubMed, Web of Science, Embase, CNKI, WanFang, and SinoMed. The CHEERS statement was used to appraise the reporting quality of included TCM economic evaluations.

Results

A total of 360 articles were retrieved, but only 38 economic evaluations met the inclusion criteria. None of the articles reported all items in the CHEERS checklist. The mean score of included articles is low at 10.93±2.62, with an average scoring rate of 51.31±10.53%. The least reported items included: “Characterizing heterogeneity,” “Conflicts of interest”, “Discount rate,” and “Study perspective,” with a reporting rate of 0.00%, 5.26%, 7.89%, and 15.79%, respectively.

Conclusion

An upward trend occurred in the quantity and quality of the economic evaluation publications of TCM in China. TCM economic evaluations are still at an early stage, with an urgent need for improving reporting quality. It may result from research experiences or different ideas between TCM and Western Medicine. Adhering to reporting guidelines like CHEERS and educating economic evaluation investigators can improve TCM economic evaluations’ reporting quality.

背景传统医学在大多数国家都有广泛的应用。在中国，中医是一种常见的初级保健，因为它具有有益的功效。本综述旨在根据《综合健康经济评估报告标准》（CHEERS）声明，评估《国家报销药品清单》（NRDL）2020版中选择性中医药经济评估的出版物报告质量。方法检索电子数据库，包括PubMed、Web of Science、Embase、CNKI、WanFang和SinoMed，检索2001年至2021年出版的《国家药品目录》（2020年版）中支持中药谈判的经济评价。CHEERS声明用于评估纳入的中医药经济评估的报告质量。结果共检索到360篇文章，但只有38篇经济评价符合纳入标准。没有一篇文章报告CHEERS检查表中的所有项目。纳入文章的平均得分较低，为10.93±2.62，平均得分率为51.31±10.53%。报告最少的项目包括：“表征异质性”、“利益冲突”、“贴现率”和“研究视角”，报告率分别为0.00%、5.26%、7.89%和15.79%。结论我国中医药经济评价出版物的数量和质量均呈上升趋势。中医药经济评价仍处于早期阶段，迫切需要提高报告质量。这可能是由于中西医研究经验的不同，也可能是中西医思想的不同。坚持CHEERS等报告准则，教育经济评价调查人员，可以提高中医药经济评价的报告质量。

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引用次数: 1