OBJECTIVE: To evaluate the effectiveness and safety of Xuanbai Chengqi decoction(宣白承气汤, XBCQD) plus Western Medicine(WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.METHO...OBJECTIVE: To evaluate the effectiveness and safety of Xuanbai Chengqi decoction(宣白承气汤, XBCQD) plus Western Medicine(WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.METHODS: Randomized controlled trials(RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019.Meta-analysis was conducted by Review Manager5.3 software. Risk ratio(RR) and mean difference(MD) with 95% confidence interval(CI) were used as effect estimation.RESULTS: Eleven RCTs were included, involving992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate[RR = 1.23, 95%CI(1.16, 1.30)], clinical pulmonary infection score [CPIS, MD =-2.02, 95%CI(-2.42,-1.63)], acute physiology and chronic health evaluation Ⅱ [APACHE Ⅱ, MD =-6.81, 95% CI(-8.26,5.37)], mechanical ventilation time [MD =-101.41,95%CI(-140.47,-62.34)], and lactic acid content in arterial blood [MD =-2.41, 95%CI(-2.64,-2.18)].CONCLUSION: XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.展开更多
OBJECTIVE: To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease.METHODS: Journal databases were searched for relevant articles in the last 30 years. Artic...OBJECTIVE: To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease.METHODS: Journal databases were searched for relevant articles in the last 30 years. Articles were reviewed for symptom patterns of Parkinson's disease and analyzed using frequency analysis, cluster analysis, and other methods of data extraction.RESULTS: The analyses indicated that the most frequent symptom patterns of Parkinson's disease are Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, blood stasis and wind stirring, and deficiency of Yin and Yang.CONCLUSION: Taken together, the analyses identified the primary symptom patterns of Parkinson's disease as Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, and blood stasis and wind stirring.展开更多
OBJECTIVE:To describe a protocol to assess the effects of Traditional Chinese Medicine(TCM)on patients with coronary heart disease(CHD)showing symptoms of phlegm-heat-stasis symptom pattern.METHODS:This is a single-bl...OBJECTIVE:To describe a protocol to assess the effects of Traditional Chinese Medicine(TCM)on patients with coronary heart disease(CHD)showing symptoms of phlegm-heat-stasis symptom pattern.METHODS:This is a single-blind randomized controlled trial that will be conducted in the First Teaching Hospital of Tianjin University of TCM and 60 patients with CHD showing phlegm-heat-stasis symptom pattern will be included.Patients will be randomly divided into either a treatment group(Qingre Huatan formulae+Western Medicine)or to acontrol group(conventional Western Medicine only)for 7-14 d.Primary patient outcomes will be vascular endothelial function and quality of life.Measurement data will be expressed as mean±standard deviation using t-test analysis or repeated-measure variance analysis.Enumeration data will be expressed by cases and percentages,usingχ^(2) analysis,and rank sum test will be used for ranked data.RESULTS:This study further verified the effectiveness and safety of Qingre Huatan formulae for the phlegm-heat-stasis syndrome pattern of CHD on the basis of previous studies on the characteristics of syndromes and medication rules.DISCUSSION:Phlegm-heat-stasis symptom pattern has become a common manifestation in CHD.Standardized Western medications together with TCM have been extensively used in China and have developed into a comprehensive treatment model.Our trial will help formulate recommendations for symptom maintenance and provide clinical evidence for the application of TCM for patients with CHD showing phlegm-heat-stasis symptom pattern.展开更多
OBJECTIVE: To investigate the in vivo inhibitory effects of sodium houttuyfonate(SH) on symptom pattern of Qi-deficiency in rats induced by infection of bacterial biofilm on rat respiratory tract.METHODS: Symptom patt...OBJECTIVE: To investigate the in vivo inhibitory effects of sodium houttuyfonate(SH) on symptom pattern of Qi-deficiency in rats induced by infection of bacterial biofilm on rat respiratory tract.METHODS: Symptom pattern is a term used in Traditional Chinese Medicine(TCM) to define a cluster of symptoms in a medical condition. Based on the pattern, TCM therapies are administered. The symptom pattern used in this study was lung-Qi deficiency pattern identified in rats, which was induced by nasal intubation drip of Pseudomonas aeruginosa(P. aeruginosa)(two strains) to form bacterial biofilm on airway combined with stimulation of cold and fatigue. We measured the variations of the symptoms of the pattern, weight, spleen and thymus index, blood gas, lung bronchial tissue pathology and cytokine of rat in different treatments and control groups.RESULTS: The rats of SH-treatment groups had not showed typical symptoms comparing with model group in the early stage of infection. The weight,spleen and thymus index of the SH-treatment groups were significantly higher comparing with untreated model group. The SH-treatment groups also showed higher O2 partial pressure and lower CO2 partial pressure than model group. Furthermore, we found that the bronchopulmonary section of SH-treatment groups not showed typical pathogenic variation in model group. The comparison of cytokine concentration in different groups indicated that SH could prevent the over-production of cytokine to reduce the inflammation occurrence.CONCLUSION: In the early stage of airway infection by biofilm of P. aeruginosa, application of SH can prevent the occurrence of lung-Qi deficiency pattern.展开更多
OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positive...OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern.Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms.RESULTS: We ascertained the results of six patterns.There were three categories for the pattern of accumulation of damp heat in the spleen-stomach(0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach(0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency(0.013 89).There were three categories for the pattern of spleen-stomach deficiency cold(0.009 15). There were five categories for the pattern of liver-Qistagnation(0.01910).There were four categories for the pattern of stagnant heat in the liver-stomach(0.00585).CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.展开更多
Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(...Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.展开更多
文摘OBJECTIVE: To evaluate the effectiveness and safety of Xuanbai Chengqi decoction(宣白承气汤, XBCQD) plus Western Medicine(WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.METHODS: Randomized controlled trials(RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019.Meta-analysis was conducted by Review Manager5.3 software. Risk ratio(RR) and mean difference(MD) with 95% confidence interval(CI) were used as effect estimation.RESULTS: Eleven RCTs were included, involving992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate[RR = 1.23, 95%CI(1.16, 1.30)], clinical pulmonary infection score [CPIS, MD =-2.02, 95%CI(-2.42,-1.63)], acute physiology and chronic health evaluation Ⅱ [APACHE Ⅱ, MD =-6.81, 95% CI(-8.26,5.37)], mechanical ventilation time [MD =-101.41,95%CI(-140.47,-62.34)], and lactic acid content in arterial blood [MD =-2.41, 95%CI(-2.64,-2.18)].CONCLUSION: XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.
基金Supported by Surface Project of National Natural Science Foundation of China,"TCM Compound Rehmannia Formula Regulating Basal Ganglia Loop to Treat Parkinson's Disease"(No.30973722)Surface Project of National Natural Science Foundation of China"Mechanism of TCM Compound Rehmannia Granule Regulating MAPK/ERK Signaling Pathway in Parkinson's Disease"(No.81573899)+2 种基金Shanghai TCM Research and Technology Support Project"Development of TCM Compound Rehmannia Granule Treating Parkinson's Disease"(No.12401900302)Shanghai TCM Research and Technology Support Project"Toxicological Research on TCM Compound Rehmannia Granules Treating Parkinson's Disease"(No.16401902400)Shanghai Municipal Health Bureau Scientific Research Project"Based on the Neural Plasticity Compound Rehmannia Treating Parkinson's Disease"(No.2012J009A)
文摘OBJECTIVE: To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease.METHODS: Journal databases were searched for relevant articles in the last 30 years. Articles were reviewed for symptom patterns of Parkinson's disease and analyzed using frequency analysis, cluster analysis, and other methods of data extraction.RESULTS: The analyses indicated that the most frequent symptom patterns of Parkinson's disease are Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, blood stasis and wind stirring, and deficiency of Yin and Yang.CONCLUSION: Taken together, the analyses identified the primary symptom patterns of Parkinson's disease as Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, and blood stasis and wind stirring.
基金Supported by the National Administration of Traditional Chinese Medicine,Research Project for Practice Development of National Traditional Chinese Medicine Clinical Research Bases:the effects of Traditional Chinese Medicine on Vascular Endothelial Function and Quality of Life in coronary heart disease showing phlegm-heat-stasis symptom pattern(No.JDZX2015003)。
文摘OBJECTIVE:To describe a protocol to assess the effects of Traditional Chinese Medicine(TCM)on patients with coronary heart disease(CHD)showing symptoms of phlegm-heat-stasis symptom pattern.METHODS:This is a single-blind randomized controlled trial that will be conducted in the First Teaching Hospital of Tianjin University of TCM and 60 patients with CHD showing phlegm-heat-stasis symptom pattern will be included.Patients will be randomly divided into either a treatment group(Qingre Huatan formulae+Western Medicine)or to acontrol group(conventional Western Medicine only)for 7-14 d.Primary patient outcomes will be vascular endothelial function and quality of life.Measurement data will be expressed as mean±standard deviation using t-test analysis or repeated-measure variance analysis.Enumeration data will be expressed by cases and percentages,usingχ^(2) analysis,and rank sum test will be used for ranked data.RESULTS:This study further verified the effectiveness and safety of Qingre Huatan formulae for the phlegm-heat-stasis syndrome pattern of CHD on the basis of previous studies on the characteristics of syndromes and medication rules.DISCUSSION:Phlegm-heat-stasis symptom pattern has become a common manifestation in CHD.Standardized Western medications together with TCM have been extensively used in China and have developed into a comprehensive treatment model.Our trial will help formulate recommendations for symptom maintenance and provide clinical evidence for the application of TCM for patients with CHD showing phlegm-heat-stasis symptom pattern.
基金Supported by General Project of National Natural Science Foundation of China(No.81173629)Youth Project of National Natural Science Foundation of China(No.81503115)Key Project of Natural Science Foundation of Anhui University,China(No.KJ2015A139)
文摘OBJECTIVE: To investigate the in vivo inhibitory effects of sodium houttuyfonate(SH) on symptom pattern of Qi-deficiency in rats induced by infection of bacterial biofilm on rat respiratory tract.METHODS: Symptom pattern is a term used in Traditional Chinese Medicine(TCM) to define a cluster of symptoms in a medical condition. Based on the pattern, TCM therapies are administered. The symptom pattern used in this study was lung-Qi deficiency pattern identified in rats, which was induced by nasal intubation drip of Pseudomonas aeruginosa(P. aeruginosa)(two strains) to form bacterial biofilm on airway combined with stimulation of cold and fatigue. We measured the variations of the symptoms of the pattern, weight, spleen and thymus index, blood gas, lung bronchial tissue pathology and cytokine of rat in different treatments and control groups.RESULTS: The rats of SH-treatment groups had not showed typical symptoms comparing with model group in the early stage of infection. The weight,spleen and thymus index of the SH-treatment groups were significantly higher comparing with untreated model group. The SH-treatment groups also showed higher O2 partial pressure and lower CO2 partial pressure than model group. Furthermore, we found that the bronchopulmonary section of SH-treatment groups not showed typical pathogenic variation in model group. The comparison of cytokine concentration in different groups indicated that SH could prevent the over-production of cytokine to reduce the inflammation occurrence.CONCLUSION: In the early stage of airway infection by biofilm of P. aeruginosa, application of SH can prevent the occurrence of lung-Qi deficiency pattern.
基金Supported by the National Natural Science Foundation of China[the Patterns Differentiation Mode of Main TCM Clinical Symptoms Based on Complex System Method(No.81270050)Information Extraction From TCM Inquiry and the Deducting Method of Patterns Differentiation Based on Feature Selection(No.30901897)+2 种基金Common Syndrome Diagnosis of Traditional Chinese Medicine Based on The Integration of Four Diagnosis Methods(No.81173199)]College Students' Scientific Innovation Foundation of Shanghai University of TCM[SHUTCMCXHDZ(2011)03]the Foundation for Training Talents of National Basic Scientific Research(No.J1103607)
文摘OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern.Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms.RESULTS: We ascertained the results of six patterns.There were three categories for the pattern of accumulation of damp heat in the spleen-stomach(0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach(0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency(0.013 89).There were three categories for the pattern of spleen-stomach deficiency cold(0.009 15). There were five categories for the pattern of liver-Qistagnation(0.01910).There were four categories for the pattern of stagnant heat in the liver-stomach(0.00585).CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.
基金small private donations to the Sleep&Human Health Institute.
文摘Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.
