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Tuina alleviates neuropathic pain through regulate the activation of microglia and the secretion of inflammatory cytokine in spinal cord

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Journal of traditional chinese medicine 2024年第4期44卷 762-769页

作者： WU Zhiwei ZHU Qingguang KONG Lingjun SONG Pengfei ZHOU Xin GUO Guangxin ZHANG Shuaipan HE Tianxiang CHENG Yanbin FANG Min Yueyang hospital of Integrated traditional chinese and Western medicine Shanghai University of Traditional Chinese MedicineShanghai 200437China Institute of Tuina Shanghai Institute of Traditional Chinese MedicineShanghai 200437China Shuguang hospital Shanghai University of Traditional Chinese MedicineShanghai 200021China Department of Acupuncture and Tuina Shanghai University of Traditional Chinese MedicineShanghai 201203China

OBJECTIVE:To observe the analgesic effects of Tuina on neuropathic pain(NPP)and the underlying ***:Forty-eight Sprague-Dawley(SD)rats were assigned by random into three treatment groups:sham,chronic constriction injury(CCI),and *** group contained sixteen *** model was generated by ligating the right sciatic *** changes of CCI were assessed by the paw withdrawal threshold(PWT)and paw withdrawal latency(PWL).In addition,biochemical techniques such as immunofluorescence staining,enzyme-linked immunosorbent assay(ELISA)and Western blotting were used to profile levels of microglia activation and inflammatory factors in the spinal dorsal horn(SDH)of ***(clockwise pressing and rubbing)was performed at Chengshan(BL57)to observe the analgesic effects on CCI rats and the underlying ***:Rats with CCI experienced significant reduction in the PWT and PWL of the right hind paw relative to CCI group at day *** treatment rescued this situation significantly on days 10 and ***,Iba-1,microglia M1 receptor CD68,tumor necrosis factor-α(TNF-α),and interleukin-1β(IL-1β)were higher in the right SDH for CCI group compared to the sham group on day *** expected,Tuina partially downregulated the CCI-induced overexpressed Iba-1,CD68,TNF-α,and IL-1βin the SDH of CCI ***:Tuina induces a time-dependent cumulative analgesic effect in CCI rats by inhibiting the activation of microglia and the secretion of IL-1βand TNF-αin SDH.

关键词： Tuina neuralgia microglia inflammatory cytokine spinal cord

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Effectiveness and safety of acupuncture in treatment of pregnancyrelated symptoms:a systematic review and Meta-analysis

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Journal of traditional chinese medicine 2024年第1期44卷 16-26页

作者： LIU Tingting LIU Tongou LIU Mingfu School of traditional chinese medicine Clinical medicine Hubei University of Traditional Chinese MedicineWuhan 430000China First Clinical College of Hubei University of traditional chinese medicine Wuhan 430000China Department of Acupuncture and Tuina Affiliated Hospital of Hubei University of Traditional Chinese MedicineHubei Provincial Hospital of Traditional Chinese MedicineWuhan 430000China

OBJECTIVE:To systematically evaluate the efficacy and safety of acupuncture(AM)in the treatment of pregnancyrelated symptoms such as acute vomiting during ***:We comprehensively searched the available literature up to November 2021,including Pub Med,Embase,Cochrane Library,chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database,for randomized controlled trials(RCTs)on AM for the treatment of severe vomiting,insomnia,pharyngeal and pelvic pain,mood abnormalities,and dyspepsia during ***:Sixteen RCTs with a cumulative sample size of 1178 cases were *** these,964 patients were included in the *** Meta-analysis results showed that AM was more efficient than Western medicine in treating discomfort during pregnancy[odds ratio(OR)=1.19,95%confidence interval(CI)(1.11,1.28),P<0.01].AM was better than the control group in improving the visual analog scale scores[standard mean difference(SMD)=0.62,95%CI(0.53,0.71),P<0.01].AM was superior to the control group in improving Numerical Rating Scale(NRS)symptom scores[OR=7.31,95%CI(3.36,15.94),P<0.01].There was no significant difference in adverse effects between the AM and sham-AM groups and the analgesic drug group[OR=0.70,95%CI(0.39,1.28),P=0.25],but the treatment and control groups had mild adverse effects with a low ***:AM is more effective than other treatments or pharmacotherapy alone in the treatment of pregnancy-related symptoms,and is relatively ***,the quality of the included trials was rather poor,and high-quality studies are required to confirm our findings.

关键词： acupuncture pregnancy nausea vomiting sleep initiation and maintenance disorders low back pain pelvic pain mood abnormalities Meta-analysis systematic review

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The acceptance of traditional chinese medicine among patients with Parkinson's disease:A hospital survey

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Journal of Integrative medicine 2024年第2期22卷 180-187页

作者： Peng Wang Jing Hong Zhu-qian Tang Bi-zhen Gong Xiao-rong Qi Han Jiang Bo Pan Qi Chen Postgraduate School Medical School of Chinese People’s Liberation ArmyBeijing 100853China Senior Department of traditional chinese medicine the Sixth Medical Center of PLA General HospitalBeijing 100853China Department of Integration of chinese and Western medicine School of Basic Medical SciencesPeking UniversityBeijing 100191China Department of Integrative Oncology the First Affiliated Hospital of Naval Medical UniversityShanghai 200433China School of traditional chinese medicine Naval Medical UniversityShanghai 200433China School of Pharmacy Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina Department of Dermatology the First Clinical Medical CollegeAnhui University of Chinese MedicineHefei 230012Anhui ProvinceChina

Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of *** some extent,traditional chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD *** purpose of this study was to investigate the attitude,acceptance,and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary ***:A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023.A self-report questionnaire was developed to investigate PD patients’attitudes and acceptance of TCM based on the *** logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM ***:A total of 397 patients completed the questionnaire,of which 78.09%were willing to be treated with TCM and 21.91%indicated that they were not willing to use *** logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic *** included education level of a bachelor’s degree(odds ratio[OR)=8.554;95%confidence interval[CI]:4.112–17.794;P<0.001,vs junior high school education),living in an urban setting(OR=8.022;95%CI:4.577–14.060;P<0.001,vs rural),having other underlying diseases(OR=5.126;95%CI:3.078–8.537;P<0.001,vs none),having previously used TCM(OR=3.083;95%CI:1.852–5.134;P<0.001,vs not used),believing that TCM therapy is safe(OR=3.530;95%CI:1.446–8.616;P=0.006,vs not thought),believing that TCM therapy is effective(OR=3.859;95%CI:1.482–10.047;P=0.006,vs not understood),and being willing to discuss ongoing TCM therapy with an attending physician(OR=62.468;95%CI:30.350–128.574;P<0.001,vs not informed).Conclusion:This study initially investigated the acceptance

关键词： Parkinson's disease traditional chinese medicine Cross-sectional study

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Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A multi-centre,randomised, double-blind, placebo-controlled trial

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Journal of Integrative medicine 2024年第5期22卷 561-569页

作者： Hui-zhi Zhu Cheng-yi Li Liang-ji Liu Jia-bing Tong Zhi-hui Lan Shu-guang Tian Qiao Li Xiang-li Tong Ji-feng Wu Zhen-gang Zhu Su-yun Li Jian-sheng Li Department of Respiratory medicine the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine Graduate School Anhui University of Traditional Chinese Medicine Department of Respiratory medicine Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine Department of Respiratory Diseases the First Affiliated Hospital of Henan University of Traditional Chinese Medicine Department of Pulmonary Diseases Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine Department of Respiratory and Critical Care medicine Jiangxi Province Hospital of Integrated Chinese and Western Medicine Department of Respiratory medicine the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and chinese medicine Development of Henan Province

Background: Chronic obstructive pulmonary disease(COPD), a common respiratory disease, can be effectively treated by traditional chinese medicine(TCM). Qingfei Huatan, a TCM formula, has been reported to effectively alleviate the clinical symptoms of COPD patients. However, there is a lack of multi-centre,randomised, double-blind, controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective: This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD, thereby providing high-quality clinical ***, setting, participants and interventions: A total of 276 patients with AECOPD were included in this multi-centre, randomised, double-blind, placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1. Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day, for 14 days, in addition to Western medicine treatment. All patients were followed up for 3 *** outcome measures: The primary outcome was time taken to symptom stabilisation. The secondary outcomes included duration of antibiotic use, clinical symptom and sign score, TCM syndrome score, dyspnoea score, and quality of life(QOL) score. Meanwhile, the safety of the formula was assessed through routine urine and stool tests, electrocardiograms, liver and kidney function tests, and the observation of adverse events throughout the ***: The time taken for effective stabilisation(P < 0.05) and obvious stabilisation(P < 0.01), and the duration of antibiotic use(P < 0.05) were significantly shorter in the treatment group than in the control group. On days 6, 9, 12 and 14 of treatment, clinical symptom and sign score decreased in both groups,particularly in the treatment group(P < 0.01). On days 9, 12 and 14 of treatment, the TCM syndrome scores of both groups were reduced(P

关键词： Acute exacerbation of chronic obstructive pulmonary disease Clinical trial Syndrome of phlegm-heat congesting lung Qingfei Huatan formula traditional chinese medicine

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Potassium dehydroandrographolide succinate regulates the MyD88/CDH13 signaling pathway to enhance vascular injuryinduced pathological vascular remodeling

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chinese Journal of Natural medicines 2024年第1期22卷 62-74页

作者： GUO Qiru LI Jiali WANG Zheng WU Xiao JIN Zhong ZHU Song LI Hongfei ZHANG Delai HU Wangming XU Huan YANG Lan SHI Liangqin WANG Yong College of Basic medicine Chengdu University of Traditional Chinese MedicineChengdu 610000China Chengdu University of traditional chinese medicine Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610000China

Pathological vascular remodeling is a hallmark of various vascular *** research has established the significance of andrographolide in maintaining gastric vascular homeostasis and its pivotal role in modulating endothelial barrier dysfunction,which leads to pathological vascular *** dehydroandrographolide succinate(PDA),a derivative of andrographolide,has been clinically utilized in the treatment of inflammatory diseases precipitated by viral *** study investigates the potential of PDA in regulating pathological vascular *** effect of PDA on vascular remodeling was assessed through the complete ligation of the carotid artery in C57BL/6 *** approaches,including rat aortic primary smooth muscle cell culture,flow cytometry,bromodeoxyuridine(BrdU)incorporation assay,Boyden chamber cell migration assay,spheroid sprouting assay,and Matrigel-based tube formation assay,were employed to evaluate the influence of PDA on the proliferation and motility of smooth muscle cells(SMCs).Molecular docking simulations and co-immunoprecipitation assays were conducted to examine protein *** results revealed that PDA exacerbates vascular injury-induced pathological remodeling,as evidenced by enhanced neointima *** treatment significantly increased the proliferation and migration of *** mechanistic studies disclosed that PDA upregulated myeloid differentiation factor 88(MyD88)expression in SMCs and interacted with T-cadherin(CDH13).This interaction augmented proliferation,migration,and extracellular matrix deposition,culminating in pathological vascular *** findings underscore the critical role of PDA in the regulation of pathological vascular remodeling,mediated through the MyD88/CDH13 signaling pathway.

关键词： Potassium dehydroandrographolide succinate Smooth muscle cell Myeloid differentiation factor 88 T-cadherin Pathological vascular remodeling

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Autophagy plays a pro-apoptotic role in arsenic trioxide-induced cell death of liver cancer

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Journal of Integrative medicine 2024年第3期22卷 295-302页

作者： Zhengting Deng Shufang Liang Guokai Huang Yuqian Wang Xiaoyu Tu Yani Zhang Shu Li Tao Liu Binbin Cheng Taizhou hospital of traditional chinese medicine Nanjing University of Chinese MedicineTaizhou 225300Jiangsu ProvinceChina Oncology Department of traditional chinese medicine The First Affiliated Hospital of Naval Medical UniversityShanghai 200433China School of traditional chinese medicine Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina Department of Gastroenterology Baoshan Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 201900China

Objective: The effects of arsenic trioxide(As2O3) on hepatocellular carcinoma have been documented widely. Autophagy plays dual roles in the survival and death of cancer cells. Therefore, we investigated the exact role of autophagy in As2O3-induced apoptosis in liver cancer ***: The viability of hepatoma cells was determined using the MTT assay with or without fetal bovine serum. The rate of apoptosis in liver cancer cells treated with As2O3was evaluated using flow cytometry, Hoechst 33258 staining, and TUNEL assays. The rate of autophagy among liver cancer cells treated with As2O3was detected using immunofluorescence, Western blot assay and transmission electron ***: Upon treatment with As2O3, the viability of HepG2 and SMMC-7721 cells was decreased in a time-and dose-dependent manner. The apoptosis rates of both liver cancer cell lines increased with the concentration of As2O3, as shown by flow cytometry. Apoptosis in liver cancer cells treated with As2O3was also shown by the activation of the caspase cascade and the regulation of Bcl-2/Bax ***, As2O3treatment induced autophagy in liver cancer cells;this finding was supported by Western blot, immunofluorescence of LC3-II and beclin 1, and transmission electron microscopy. In liver cancer cells, As2O3inhibited the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR) signal pathway that plays a vital role in both apoptosis and autophagy. The PI3K activator SC-79 partially reversed As2O3-induced autophagy and apoptosis. Furthermore, inhibiting autophagy with 3-methyladenine partially reversed the negative effects of As2O3on cell *** starvation increased autophagy and amplified the effect of As2O3on cell ***: As2O3induces apoptosis and autophagy in liver cancer cells. Autophagy induced by As2O3may have a proapoptotic effect that helps to reduce the viability of liver cancer cells. This study provides novel insights

关键词： Apoptosis Arsenic trioxide Autophagy Primary liver cancer

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Efficacyand Safetyof Huashi Baidu Granules in Treating Patients with SARS-CoV-2Omicron Variant: A Single-Center Retrospective Cohort Study

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chinese Journal of Integrative medicine 2024年第2期30卷 107-114页

作者： CHEN Cai-yu ZHANG Wen XU Xiang-ru PU Yu-ting TU Ya-dan PENG Wei YAO Xuan ZHOU Shuang FANG Bang-jiang Department of Emergency Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai(200032)China Department of Classical traditional chinese medicine Chongqing Hospital of Traditional Chinese MedicineChongqing(400021)China Acupuncture and Massage College Shanghai University of Traditional Chinese MedicineShanghai(201203)China Institute of Emergency and Critical Care medicine Shanghai University of Traditional Chinese MedicineShanghai(200032)China

Objective:To evaluate the efficacy and safety of Huashi Baidu Granules(HSBD)in treating patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron ***:A single-center retrospective cohort study was conducted during COVID-19 Omicron epidemic in the Mobile Cabin hospital of Shanghai New International Expo Center from April 1st to May 23rd,*** COVID-19 patients with asymptomatic or mild infection were assigned to the treatment group(HSBD users)and the control group(non-HSBD users).After propensity score matching in a 1:1 ratio,496 HSBD users of treatment group were matched by propensity score to 496 non-HSBD *** in the treatment group were administrated HSBD(5 g/bag)orally for 1 bag twice a day for 7 consecutive *** in the control group received standard care and routine *** primary outcomes were the negative conversion time of nucleic acid and negative conversion rate at day *** outcomes included the hospitalized days,the time of the first nucleic acid negative conversion,and new-onset symptoms in asymptomatic *** events(AEs)that occurred during the study were *** subgroup analysis was conducted in vaccinated(378 HSBD users and 390 non-HSBD users)and unvaccinated patients(118 HSBD users and 106 non-HSBD users).Results:The median negative conversion time of nucleic acid in the treatment group was significantly shortened than the control group[3 days(IQR:2-5 days)vs.5 days(IQR:4-6 days);Phospitalized days in the treatment group were significantly reduced[10 days(IQR:8-11 days)vs.11 days(IQR:10.25-12 days);P<0.01].The time of the first nucleic acid negative conversion had significant differences between the treatment and control groups[3 days(IQR:2-4 days)vs.5 days(IQR:

关键词： Huashi Baidu Granule severe acute respiratory syndrome coronavirus 2 Omicron variant retrospective cohort trial chinese medicine

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Efficacy of Huoxue Qianyang Qutan Recipe on essential hypertension:A randomized,double-blind,placebo-controlled trial

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Journal of Integrative medicine 2024年第4期22卷 484-492页

作者： Jun Xie Yu-long Ma Ming-tai Gui Lei Yao Jian-hua Li Ming-zhu Wang Xun-jie Zhou Yi-fan Wang Ming-yi Zhao Hui Cao Bo Lu De-yu Fu Department of Cardiology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China Shanghai University of traditional chinese medicine Shanghai 200120China

Background:Hypertension,a prevalent disease,is a significant risk factor for coronary heart *** Qianyang Qutan Recipe (HQQR),a traditional chinese herbal remedy,has been used for treating hypertension over several ***:This study assesses HQQR’s efficacy for controlling blood pressure among patients with hypertension related to blood stasis,yang hyperactivity and ***,setting,participants and interventions:A randomized controlled trial was conducted at the Yueyang hospital of Integrated traditional chinese and Western medicine,Shanghai University of traditional chinese medicine,China,from July 2020 to June *** components of HQQR were identified using thin-layer chromatography and high-performance liquid *** aged18–80 years,exhibiting traditional chinese medicine syndromes of blood stasis,yang hyperactivity or phlegm,along with grades 1 or 2 hypertension,were randomly categorized into two *** intervention group was given HQQR granules alongside conventional hypertension treatment,while the control group was given placebo granules in addition to conventional treatment for 12 *** outcome measures:The primary outcome was clinic blood pressure,whereas secondary outcomes included metabolic indices (e.g.,homeostasis model assessment of insulin resistance[HOMA-IR],total cholesterol[TC],low-density lipoprotein cholesterol and triglyceride),target organ damage indices (left ventricular mass index and urinary albumin creatinine ratio[UACR]) and inflammation indices(interleukin-6[IL-6]and high-sensitivity C-reactive protein[hs-CRP]).Results:HQQR’s primary components were identified as salvianolic acid B,emodin and ferulic *** the 216 participants (108 in each group),compared to the control,the intervention group exhibited significant improvements (P<0.001) in clinic systolic blood pressure ([136.24±7.63]vs[130.06±8.50]mmHg),clinic diastolic blood pressure ([84.34±8.72]vs[80.46±6.05]mmHg),home systol

关键词： Huoxue Qianyang Qutan Recipe Hypertension Target organ damage Glycolipid metabolism Inflammatory chinese herbal compound

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Impact of frailty on postoperative outcomes after hepatectomy:A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2319-2328页

作者： Yao-Jia Lv Guang-Xing Xu Jia-Rong Lan Day Surgery Ward Huzhou Central HospitalThe Affiliated Central Hospital of Huzhou UniversityHuzhou 313000Zhejiang ProvinceChina School of Basic Medical Sciences Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of medicine Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical UniversityHuzhou 313000Zhejiang ProvinceChina

BACKGROUND The impact of frailty on postoperative outcomes in patients undergoing hepatectomy is still *** To study the influence of frailty on postoperative outcomes,such as mortality,rate of complications,and length of hospitalization,following *** PubMed,EMBASE,and Scopus databases were searched for observational studies with adult(≥18 years)patients after planned/elective hepatectomy.A randomeffects model was used for all analyses,and the results are expressed as weighted mean difference(WMD),relative risk(RR),or hazards ratio(HR)with 95%confidence interval(CI).RESULTS Analysis of the 13 included studies showed a significant association of frailty with elevated risk of in-hospital mortality(RR=2.76,95%CI:2.10-3.64),mortality at 30 d(RR=4.60,95%CI:1.85-11.40),and mortality at 90 d(RR=2.52,95%CI:1.70-3.75)in the postoperative *** patients had a poorer long-term survival(HR=2.89,95%CI:1.84-4.53)and higher incidence of“any”complications(RR=1.69,95%CI:1.40-2.03)and major(grade III or higher on the Clavien-Dindo scale)complications(RR=2.69,95%CI:1.85-3.92).Frailty was correlated with markedly lengthier hospital stay(WMD=3.65,95%CI:1.45-5.85).CONCLUSION Frailty correlates with elevated risks of mortality,complications,and prolonged hospitalization,which need to be considered in surgical *** research is essential to formulate strategies for improved outcomes in this vulnerable cohort.

关键词： Frailty Frail adults Hepatic resection Hepatectomy Complications Mortality Survival Clinical outcomes Meta-analysis

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Organic Integration of traditional chinese and Western medicines—Future of Clinical Practice Guidelines of Integrated traditional chinese and Western medicines

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chinese Journal of Integrative medicine 2024年第4期30卷 359-365页

作者： XIE Ying-lan HAN Fei JIN Ying-hui DING Yan-bing GUO Jing JI Dong-xiao ZHANG Teng CHENXiao-min SHANG Hong-cai Department of traditional chinese medicine Encephalopathy Hubei Provincial Hospital of Traditional Chinese MedicineWuhan(430074)China Department of traditional chinese medicine Encephalopathy Hubei Province Traditional Chinese Medicine Research InstituteWuhan(430074)China Xuanwu hospital of traditional chinese medicine Beijing(100000)China Center for Evidence-Based and Translational medicine Zhongnan Hospital of Wuhan UniversityWuhan(430074)China College of Acupuncture and Massage College of Health and RehabilitationNanjing University of Chinese MedicineNanjing(210023)China Department of Ophthalmology Huaihe Hospital of Henan UniversityKaifengHenan Province(475000)China Ministry of Education and Beijing Key Laboratory of Internal medicine of traditional chinese medicine Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine/Ministry of Education and Beijing Key Laboratory of Internal Medicine of Traditional Chinese MedicineBeijing(100700)China

The transformation and implementation of clinical practice guidelines for integrated traditional chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the ***,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM ***,the information and quality evaluation of CPGs for integrated chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of chinese and Western medicine *** last this study aimed to lay a foundation for the further establishment of chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.

关键词： clinical practice guidelines integrated traditional chinese and Western medicine organic integration

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