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From ancient wisdom to modern science:Gut microbiota sheds light on property theory of traditional chinese medicine

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Journal of Integrative medicine 2024年第4期22卷 413-444页

作者： Ya-nan Yang Jia-guo Zhan Ying Cao Chong-ming Wu School of chinese Materia Medica Tianjin University of Traditional Chinese Medicine Tianjin Key Laboratory of Therapeutic Substance of traditional chinese medicine

The property theory of traditional chinese medicine(TCM) has been practiced for thousands of years,playing a pivotal role in the clinical application of TCM. While advancements in energy metabolism,chemical composition analysis, machine learning, ion current modeling, and supercritical fluid technology have provided valuable insight into how aspects of TCM property theory may be measured, these studies only capture specific aspects of TCM property theory in isolation, overlooking the holistic perspective inherent in TCM. To systematically investigate the modern interpretation of the TCM property theory from multidimensional perspectives, we consulted the chinese Pharmacopoeia(2020 edition) to compile a list of chinese materia medica(CMM). Then, using the Latin names of each CMM and gut microbiota as keywords, we searched the PubMed database for relevant research on gut microbiota and CMM. The regulatory patterns of different herbs on gut microbiota were then summarized from the perspectives of the four natures, the five flavors and the meridian tropism. In terms of the four natures, we found that warm-natured medicines promoted the colonization of specific beneficial bacteria,while cold-natured medicines boosted populations of some beneficial bacteria while suppressing pathogenic bacteria. Analysis of the five flavors revealed that sweet-flavored and bitter-flavored CMMs positively influenced beneficial bacteria while inhibiting harmful bacteria. CMMs with different meridian tropism exhibited complex modulative patterns on gut microbiota, with Jueyin(Liver) and Taiyin(Lung) meridian CMMs generally exerting a stronger effect. The gut microbiota may be a biological indicator for characterizing the TCM property theory, which not only enhances our understanding of classic TCM theory but also contributes to its scientific advancement and application in healthcare.

关键词： Five flavors Four natures Gut microbiota Meridian tropism Property theory traditional chinese medicine

Individualized traditional chinese medicine treatment vs antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study

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Journal of traditional chinese medicine 2024年第3期44卷 524-529页

作者： GU Xiangchen QIU Meisi XIE Lin CHEN Min DENG Yueyi ZHANG Changming JIAN Guihua WANG Chen WANG Yi Department of Nephrology Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine Department of Nephrology Rizhao Hospital of Traditional Chinese Medicine Department of Nephrology Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Department of Nephrology Shanghai Municipal Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Department of Nephrology the Sixth People's Hospital Affiliated Shanghai Jiaotong University Department of Nephrology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

OBJECTIVE: To systematically assess the effects of individualized chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized chinese medicine group(n = 114) and a control group(n = 116). Patients in the chinese medicine group received individualized chinese herbs, which were evaluated for syndrome differentiation.Patients in the control group received antibiotic treatment combined with a chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate,traditional chinese medicine(TCM) syndrome scores,36-item Short Form Survey(SF-36) score, and urine secretory immunoglobulin A(SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the chinese medicine group exhibited significant decreases in both short-and longterm UTI recurrence rates compared with the control group(P chinese medicine and control groups were significant(P chinese medicine group were also significantly higher than those in the control group after treatment(P chinese medicine group also demonstrated a significant increase in urine SIg A expression. CONCLUSION: Taken together, compared to the oftenused long-term antimicrobial prophylaxis during the remission stage of r UTIs, treating patients with an individualized chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

关键词： chinese traditional immunoglobulin A, secretory medicine quality of life randomized controlled trial syndrome differentiation urinary tract infections

traditional chinese medicine Integrated Responsive Microneedles for Systemic Sclerosis Treatment

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Research 2024年第1期2023卷 139-147页

作者： Xi Luan Xiaoxuan Zhang Min Nie Yuanjin Zhao Department of Rheumatology and Immunology Nanjing Drum Tower HospitalSchool of PharmacyClinical College of Traditional Chinese and Western MedicineNanjing University of Chinese MedicineNanjing 210023China State Key Laboratory of Bioelectronics School of Biological Science and Medical EngineeringSoutheast UniversityNanjing 210096China

traditional chinese medicine,such as Tripterygium wilfordii and Paeonia lactiflora,has potential values in treating systemic sclerosis(SSc)and other autoimmune diseases,while their toxic side effect elimination and precise tropical drug delivery are still challenges.Here,we present multiple traditional chinese medicine integrated photoresponsive black phosphorus(BP)microneedles(MNs)with the desired features for the SSc treatment.By employing a template-assisted layer-by-layer curing method,such MNs with triptolide(TP)/paeoniflorin(Pae)needle tips and BP-hydrogel needle bottoms could be well generated.The combined administration of TP and Pae can not only provide anti-inflammatory,detoxification,and immunomodulatory effects to treat skin lesions in the early stage of SSc but also remarkably reduce the toxicity of single drug delivery.Besides,the additive BPs possess good biocompatibility and near-infrared(NIR)responsiveness,imparting the MN photothermal-controlled drug release capability.Based on these features,we have demonstrated that the traditional chinese medicine integrated responsive MNs could effectively improve skin fibrosis and telangiectasia,reduce collagen deposition,and reduce epidermal thickness in the SSc mouse models.These results indicated that the proposed chinese medicine integrated responsive MNs had enormous potential in clinical therapy of SSc and other diseases.

关键词： needle precise template

Knee osteoarthritis:A review of animal models and intervention of traditional chinese medicine

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Animal Models and Experimental medicine 2024年第2期7卷 114-126页

作者： Xuyu Song Ying Liu Siyi Chen Lei Zhang Huijie Zhang Xianhui Shen Hang Du Rong Sun Orthopaedic trauma surgery The Second Hospital of Shandong UniversityJinanShandongChina Academy of traditional chinese medicine Tianjin University of Traditional Chinese MedicineTianjinChina Department of traditional chinese medicine The Second Hospital of Shandong UniversityJinanShandongChina College of pharmacy Shandong University of Traditional Chinese MedicineJinanShandongChina The Second Clinical College of Shandong University Shandong UniversityJinanShandongChina Advanced Medical Research Institute Shandong UniversityJinanShandongChina The Second Hospital of Shandong University JinanShandongChina

Background:Knee osteoarthritis(KOA)characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults.The pathophysiology of KOA remains poorly understood,as it involves complex mechanisms that result in the same outcome.Consequently,researchers are interested in studying KOA and require appropriate animal models for basic research.chinese herbal compounds,which consist of multiple herbs with diverse pharmacological properties,possess characteristics such as multicomponent,multipathway,and multitarget effects.The potential benefits in the treatment of KOA continue to attract attention.Purpose:This study aims to provide a comprehensive overview of the advantages,limitations,and specific considerations in selecting different species and methods for KOA animal models.This will help researchers make informed decisions when choosing an animal model.Methods:Online academic databases(e.g.,PubMed,Google Scholar,Web of Science,and CNKI)were searched using the search terms“knee osteoarthritis,”“animal models,”“traditional chinese medicine,”and their combinations,primarily including KOA studies published from 2010 to 2023.Results:Based on literature retrieval,this review provides a comprehensive overview of the methods of establishing KOA animal models;introduces the current status of advantages and disadvantages of various animal models,including mice,rats,rabbits,dogs,and sheep/goats;and presents the current status of methods used to establish KOA animal models.Conclusion:This study provides a review of the animal models used in recent KOA research,discusses the common modeling methods,and emphasizes the role of traditional chinese medicine compounds in the treatment of KOA.

关键词： animal models knee osteoarthritis system review traditional chinese medicine

Research on the development methodology for clinical practice guidelines for organic integration of traditional chinese medicine and Western medicine

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Military Medical Research 2024年第3期11卷 313-322页

作者： Ying-Hui Jin Yan-Ping Wang Ying-Lan Xie Gui-Hua Tian Xiao-Yu Zhang Nan-Nan Shi Ke-Hu Yang Xin Sun Yao-Long Chen Da-Rong Wu Xin-Feng Guo Long Ge Chen Zhao Cheng Lu Yin Jiang Jing Guo Si-Yu Yan Yong-Bo Wang Qiao Huang Xiang-Ying Ren Ying-Yue Rao Yun-Yun Wang Meng-Qian Yuan Xian-Tao Zeng Hong-Cai Shang Center for Evidence-Based and Translational medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Basic Research in Clinical medicine China Academy of Chinese Medical SciencesBeijing 100700China China Center for Evidence Based traditional chinese medicine Beijing 100029China Hubei Provincial Hospital of traditional chinese medicine Wuhan 430074China Key Laboratory of chinese Internal medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China Evidence-Based medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China China Center for Evidence-Based medicine West China Hospital of Sichuan UniversityChengdu 610041China State Key Laboratory of Dampness Syndrome of chinese medicine the Second Affliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China Evidence-based medicine Team Guangdong Provincial Hospital of Traditional Chinese MedicineGuangzhou 510120China Nanjing University of chinese medicine Nanjing 210023China Jiangsu Province Hospital of chinese medicine Nanjing 210029China

Integrated traditional chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

关键词： Methodology traditional chinese medicine Western medicine Organic integration Clinical practice guidelines(CPGs)

The combination of gut microbiota-depleted treatment and fecal microbiota transplantation is an important strategy to verify the efficacy of traditional chinese medicine though modulation of gut dysbiosis

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Journal of traditional chinese medicine 2024年第1期44卷 222-223页

作者： XING Yunqi LI Junxiang YUAN Yali MAO Tangyou Gastroenterology Department Dongfang HospitalBeijing University of Chinese MedicineBeijing 100078China Department of Hepatology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 201203China

To the Editors:We read with great interest the study recently published by Sun et al 1 entitled“Electroacupuncture at Tianshu(ST25)and Zusanli(ST36)alleviates stress-induced irritable bowel syndrome in mice by modulating gut microbiota and corticotropin-releasing factor”in which the microbial details of electroacupuncture(EA)-induced protection in irritable bowel syndrome(IBS)were investigated.

关键词： releasing treatment details

traditional chinese medicine's Spleen Strengthening and Intestinal Microecology

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Research and Inheritance of Traditional Chinese Medicine

Research and Inheritance of traditional chinese medicine 2024年第1期2卷 17-22页

作者： Li Du Fengqing Luo Sichuan Provincial Hospital of traditional chinese medicine

The"spleen"in traditional chinese medicine is the"acquired foundation"and the"source of qi and blood biochemistry".Strengthening the"spleen"is one of the important treat‐ment methods in traditional chinese medicine;The gut microbiota has been a hot topic in modern scientific research in recent years,and its nutritional and immune functions correspond to some of the functions of the spleen in traditional chinese medicine.In terms of philosophy,traditional chinese medicine emphasizes the balance between the spleen and the gut microbiota,emphasizing the importance of supporting the right and eliminating evil,preventing diseases before they occur,seeking the root cause of treat‐ment,and adapting measures to the three causes;Clinically,the treatment of obesity,con‐stipation,diarrhea and other diseases by invigorating the spleen and the treatment mechanism of acupuncture and moxibustion,chiropractic and invigorating the spleen are all related to microecology.This article combines relevant literature on traditional chinese medicine's"spleen"and"spleen health"to explore the treatment concept,clinical application,and correlation with intestinal microbiota of traditional chinese medicine's"spleen health".It also elaborates on the latest literature,aiming to exchange ideas with peers and promote research on the microbiota of traditional chinese medicine's"spleen".

关键词： traditional chinese medicine spleen traditional chinese medicine invigorates the spleen intestinal microbiota intestinal microbiota

Kuicolong-yu enema decoction retains traditional chinese medicine enema attenuates inflammatory response ulcerative colitis through TLR4/NF-κB signaling pathway

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1149-1154页

作者： Li Han Kun Tang Xiao-Li Fang Jing-Xi Xu Xi-Yun Mao Ming Li Department of Anorectal Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Anhui HospitalHefei 230001Anhui ProvinceChina Anorectal Center The First Affiliated Hospital of Anhui University of Traditional Chinese MedicineHefei 230001Anhui ProvinceChina Department of Spleen and Stomach Diseases Department of GastroenterologyAffiliated Wuhu Hospital of Traditional Chinese Medicine of Anhui College of Traditional Chinese MedicineWuhu 241000Anhui ProvinceChina

BACKGROUND Ulcer colitis(UC)is a chronic,nonspecific,and noninfectious inflammatory bowel disease.Recently,Toll-like receptors(TLRs)have been found to be closely associated with clinical inflammatory diseases.Achieving complete remission in patients with intermittent periods of activity followed by dormancy is challenging.Moreover,no study has explored the mechanism by which Kuicolong-yu enema decoction retains traditional chinese medicine enemas to attenuate the inflammatory response in UC.AIM To explore the mechanism by which Kuicolong-yu enema decoction retains traditional chinese medicine enemas to attenuate the inflammatory response in UC.METHODS This prospective clinical study included patients who met the exclusion criteria in 2020 and 2021.The patients with UC were divided into two groups(control and experimental).The peripheral blood of the experimental and control groups were collected under aseptic conditions.The expression of TLR4 protein,NF-κB,IL-6,and IL-17 was detected in the peripheral blood of patients in the experimental group and control group before and 1 month after taking the drug.Linear co rrelation analysis was used to analyze the relationship between the expression level of TLR4 protein and the expression levels of downstream signal NF-κB and inflammatory factors IL-6 and IL-17,and P<0.05 was considered statistically significant.RESULTS There were no significant differences in the patient characteristics between the control and experimental groups.The results showed that the expression levels of TLR4 and NF-κB in the experimental group were significantly lower than those in the control group(P<0.05).The levels of IL-6 and IL-17 in the experimental group were significantly lower than those in the control group(P<0.05).The TLR4 protein expression in the experimental group was positively correlated with the expression level of downstream signal NF-κB and was positively correlated with the levels of downstream inflammatory cytokines IL-6 and IL-17(r=0.823,P<0.05).CONCLUSION Kuicolong-yu enema

关键词： Ulcerative colitis TLR4 NF-κB signaling pathway Kuicolong-yu enema

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 life.To some extent,traditional chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD patients.The 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 hospital.Methods: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 questionnaire.Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM therapy.Results: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 TCM.Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime.These 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,attitude,and independent predictors of TCM use

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