Objective To compare the effectiveness of integrated traditional Chinese medicine (TCM) with Western medicine and Western medicine alone for acute episodes of withdrawal in alcoholism. Methods According to the criteria of alcohol dependence and acute alcochol withdrawal syndrome of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) , 62 consecutive patients were divided into two groups: 31 patients with odd numbers were allocated to the treatment group (4 patients were excluded because they left hospital early), 31 patients with even numbers were allocated to the control group. According to the four diagnostic methods of TCM, all patients in the treatment group were further divided into 4 types. The treatment group received valium, tiopronin, transfusion therapy and herbs (potion per day). The control group received the same therapy as the treatment group did but without oral herbs. Results Liver function, especially the difference between before and after treatment of GOT and γ-GT,the treatment group showed more improvement than the control group (P=0.046 and 0.001). The scores of anxiety and depression test, especially the HAMD, the treatment group showed more improvement than the control group (t=3.165, P=0.003). The treatment group used significantly less time than the control group (P=0.01), but no statistically significant difference was seen in the dosage of valium between the two groups (P=0.434). Conclusions The efficacy of integrated TCM with Western medicine is better than Western medicine alone for acute episodes of withdrawal in alcoholism.
目的：对中药配合肝动脉栓塞化疗（Transcatheter Arterial Chemoembolization,TACE）辅助治疗原发性肝癌随机对照试验(Randomized controlled trial,RCT)文献进行评价。方法：对国内外公开发表的有关中药配合TACE辅助治疗原发性肝癌的随机对照试验进行检索，检索数据库包括Cochrane图书馆临床对照试验库，MEDLINE、CBM、CNKI和VIP电子数据库。手工检索中文相关期刊以及附加检索相关会议论文集。质量评价采用Jadad评分量表、CONSORT标准和其他自拟评价指标进行分析。结果：共纳入103篇RCTs，其中Jadad评分得5分有1篇文献，3分1篇，2分10篇，71篇1分，其余20篇均为0分，有3篇文献报告了分配隐藏。按CONSORT标准，仅1篇(0.97%)RCT描述了如何产生随机顺序，没有RCT报道如何执行随机，其中1篇为半随机，有1篇(0.97%)RCT采用安慰剂对照，有54篇(52.43%)报道了终点指标，分别各有2篇(1.94%)报道了双盲和单盲，14篇(1359%)进行了具体统计量计算，54篇(52.43%)提供了随访记录，7篇(6.80%)报道了阴性结果，16篇(15.53%)报道不良事件，仅有1篇(0.97%)进行样本含量计算与意向性分析(ITT),有2篇(1.94%)进行分层分析，属于多中心的仅有1篇(0.97%)，均未进行伦理审批和知情同意。描述了中医证型的有3篇(2.91%)。结论:目前中药配合TACE辅助治疗原发性肝癌临床研究的方法学和报告质量尚低，且多数RCT可能存在选择性偏倚和测量性偏倚，期待更多高质量的随机双盲对照试验为临床应用提供可靠的依据。
Objective To assess the effect of integrated traditional Chinese medicine with western medicine (ICWM) in the treatment of SARS. Methods We searched MEDLINE, EMBASE, and Chinese BioMed Database ( CBM ) , and the Intemet performed handsearching in Chinese journals and reference lists. We included randomised controlled trials and prospective controlled studies of integrated Chinese medicine with western medicine versus western medicine alone in people with SARS. Three independent reviewers collected details of study population, interventions, and outcomes using a data extraction form. We conducted meta-analysis for similar data of studies.Results Nine studies (n =812) were included, all with the possibility of containing serious bias. ICWM in the treatment of SARS was associated with the following reductions: case fatality [ OR 0.32, 95% CI (0.14,0.71 ) ] , fever clearance time [ WMD -1.17, 95% CI ( -1.83, -0.50 ) , symptom remission time [ WMD-1.47, 95% CI ( - 1.96, - 0. 98) ] and the number of inflammation absorption cases [ MD 1.63, 95% CI(0.95, 2.80 ) ], having no significant difference in symptom scores of convalescents [ WMD -1.25, 95% CI ( -2.71, 0.21 ) ], cumulative dose of corticosteroids [ WMD - 236.96, 95% CI ( - 490.64, 16.73) ] and inflammation absorption mean time [ WMD 0.63, 95% CI ( - 1.33, 2.59) ] .Conclusions Due to the methodological limitations of the studies, the effect of ICWM for SARS is unclear. The apparent improvements in cases fatality, fever clearance time, syndromes remission time and numbers of inflammation absorption cases warrant further evaluation with high quality and large scale trials to be expected.
Postoperative gastrointestinal disorder (POGD) is a common complication after surgery under anesthesia. Strategies in combination with traditional Chinese medicine and Western medicine have shown some distinct effects but standardized clinical practice guidelines are not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center /Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients’ preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations include disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
ObjectiveTo evaluate the methodological quality of systematic reviews and meta-analysis (SRs/MAs) in fields of integrated Chinese-western therapy for non-small cell lung cancer (NSCLC). MethodsSRs/MAs in fields of integrated Chinese-western therapy for NSCLC were searched inPubMed, EMbase, CBM, CNKI, VIP and WanFang Data from inception to July 10th, 2016. We also handsearched relevant journals such as Chin J Evid-based Med and reference of included studies, and tried to find the grey literature for additional studies. Two researchers independently screened literature and extracted data. Then methodological quality of included SRs/MAs were evaluated by AMSTAR scale. ResultsA total of 53 SRs/MAs were included, the highest and lowest scores of methodological quality were 9 and 1, respectively. The average score was 5.98±1.50. Results on the qualities of methodology or evaluation showed that 46 SRs/MAs (88.68%) was rated as moderate and 6 (11.32%) as low． The main problems were found in such areas as preliminary design scheme, literature searching, a list of included and excluded studies, etc.. ConclusionThe methodology of SRs/MAs in fields of integrated Chinese-western therapy for NSCLC have quality problems at different levels, further improvement should be expected.
Chronic obstructive pulmonary disease (COPD), with high prevalence rate, mortality, and disability rate, and heavy burden caused by the disease, has become a major chronic disease seriously threatening public health worldwide. Chinese medicine and Western medicine both have advantages in diagnosing and treating COPD, which have been widely used in clinic. In order to improve the diagnostic and treatment level for COPD with integrated traditional Chinese and Western medicine, Chinese Medicine of internal Medicine Committee of World federation of Chinese Medicine Societies organized and established a multidisciplinary background working group, the document was formulated by referring to the formulating method and process of international guidelines in clinical practice, current evidence with the best quality, and characteristics of integrated traditional Chinese and Western medicine in treating COPD and weighing pros and cons of interventions, 13 recommendations were established, physicians can refer to this guideline to formulate individualized treatment plans in combination with the specific conditions of patients.