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  • REVIEW ARTICLE
    Guanjun Kou, Hongwei Luo, Xing Huang, Mingxue Bai, Ke Cao, Hongyu Ma, Xiang Lv
    Advanced Chinese Medicine, 2024, 1(1): 40-51. https://doi.org/10.1002/acm4.1

    Non-alcoholic fatty liver disease (NAFLD) is a metabolic liver disease characterized by the accumulation of excessive liver lipids without alcohol-induced damage. It has emerged as a significant global health issue. A recent research has indicated that dysregulation of lipid decomposition, uptake, production, oxidation, and secretion causes alterations in various types of lipids, leading to organelle dysfunction and metabolic signaling pathway impairment. Scholars propose that turbid toxin is crucial in the pathogenesis of NAFLD. This article elucidates the meaning of turbid toxin in conjunction with the current literature and analyzes the modern pathophysiological mechanism underlying the development of NAFLD, including turbid toxic substance production, related organelle involvement, biological processes, and pathways, ultimately leading to disease outcomes. The relationship between traditional Chinese medicine and the turbid toxin is also explored to establish a foundation for further mechanistic research on NAFLD.

  • COMMENTARY
    Jiaran Lin, Jiaxing Tian, Xinyi Fang, Boxun Zhang, Yingying Yang, Yu Wei, Lisha He, Ye Lei, Bin Song, Linhua Zhao, Xiaolin Tong
    Advanced Chinese Medicine, 2024, 1(1): 3-12. https://doi.org/10.1002/acm4.8

    As an important part of Chinese civilization, traditional Chinese medicine (TCM) has a long history and broad social foundation. In the development of modern medicine, TCM bears the responsibility of inheriting Chinese culture, while integrating with modern science and technology to continuously promote medical progress. The theory of “state-target differentiation and treatment” is an innovative model combining Chinese and Western medicine that has provided a new mindset and method for modernizing TCM. This theory not only guides the reconstruction of modern TCM diagnosis and treatment systems, but also strongly promotes the reconstruction of the modern herbal system. As an emerging bioinformatics technology, phenomics research can reveal biological processes dynamically and quantitatively, which will help “open the black box” of TCM by providing technical methods to reveal the nature of “state” and the mechanism of “state modulation” in TCM. TCM can provide a valuable clinical reference from the perspective of disease cognition, sort out phenomics information parameters systematically and uniformly, and provide more accurate and meaningful data for phenomics research. The in-depth combination of TCM and phenomics from the concept and technology will vigorously promote the development of human precision medicine. Modern TCM research guided by the theory of state-target differentiation and treatment can effectively improve the scientific basis and targetability of clinical treatments and can also initiate a breakthrough in the integration of Chinese and Western medicine, further promoting the profound communication and cooperation between Chinese and Western medicine, so as to achieve better development of medicine in the future.

  • RESEARCH ARTICLE
    JingYi Zhao, Min Li, KaiLe Ma, Rui Hao, LiJuan Zhou
    Advanced Chinese Medicine, 2024, 1(1): 66-78. https://doi.org/10.1002/acm4.3

    Objective: This meta-analysis evaluated the effects of Baduanjin on the metabolic status of individuals with metabolic syndrome (MetS). The aim was to identify effective interventions for MetS prevention and treatment.

    Methods: We conducted a comprehensive search of English (PubMed, Embase, Web of Science, and Cochrane Library) and Chinese (CNKI, Wanfang, Chinese Biomedical Database, VIP) databases till August 19, 2022. Randomized controlled trials (RCTs) focusing on Baduanjin for MetS patients were included. Data were pooled and assessed using the Cochrane risk-of-bias tool. The Grades of Recommendation, Assessment, Development, and Evaluation for Systematic Reviews was used to evaluate literature quality.

    Results: Eight RCTs involving 435 participants were included. Baduanjin showed significant improvements in fasting blood glucose (mean difference [MD] = −0.41, 95% confidence interval [CI] [−0.22, −0.61], p < 0.0001) and glycated hemoglobin levels (MD = −0.99, 95% CI [−0.38, −1.60], p < 0.00001). Waist-to-hip ratio (MD = −0.04, 95% CI [−0.03, −0.06], p = 0.002), body mass index (MD = −1.60, 95% CI [−0.10, −3.10], p = 0.04), fasting insulin (MD = −4.82, 95% CI [−0.15, −8.59], p = 0.01), systolic blood pressure (MD = −7.16, 95% CI [−5.16, −9.17], p < 0.00001), diastolic blood pressure (MD = −3.43, 95% CI [−0.62, −6.24], p = 0.02), total cholesterol (MD = −0.48, 95% CI [−0.10, −0.85], p = 0.01), triglycerides (MD = −0.39, 95% CI [−0.14, −0.64], p = 0.003), and low-density lipoprotein cholesterol (MD = −0.52, 95% CI [−0.10, −0.94], p = 0.01) also significantly improved. No adverse events were reported. Literature quality ranged from very low to moderate.

    Conclusions: Baduanjin effectively improves metabolic status in individuals with MetS, including blood glucose, lipid profile, obesity-related indicators, insulin levels, and blood pressure. However, the overall literature quality is moderate to low. Further rigorous RCTs are needed to explore Baduanjin's effects on MetS, considering intervention methods, content, and research methodologies.

  • REVIEW ARTICLE
    Yi Liu, Wanmu Xie, Yue Yan, Baoyi Liu, Ang Li, Yue Yang, Xinzhu Zhou, Xianbo Zuo, Zhenguo Zhai, Yong Cui
    Advanced Chinese Medicine, 2024, 1(1): 52-65. https://doi.org/10.1002/acm4.11

    In the realms of traditional Chinese medicine and Western medicine research, the skin and lungs are recognized for their integral roles in both the physiological functions and pathological mechanisms affecting the human body. These organs are not only complementary and coordinated in their physiological functions but also interact pathologically, providing feedback and influencing each other. The etiology of immune-mediated skin diseases is multifaceted, involving numerous factors beyond mere skin characteristics, often including multisystem diseases. Cutaneous and Respiratory Comorbidities denote the concurrent presence of skin and lung diseases, sharing a common pathogenic mechanism. Although research on Cutaneous and Respiratory Comorbidities has received increasing attention, the foundational theories and the specifics of related diseases remain unclear. This paper aims to elucidate the theoretical basis of both traditional Chinese and Western medicine concerning immune-mediated Cutaneous and Respiratory Comorbidities, thereby laying a groundwork for the early detection and integrated treatment of these diseases.

  • EDITORIAL
    Yong Cui
    Advanced Chinese Medicine, 2024, 1(1): 1-2. https://doi.org/10.1002/acm4.9
  • REVIEW ARTICLE
    Qiao Wang, Hongshuai Cao, Peizhao Li, Chunyan Li, Zaixiang Shi, Jingyi Ren
    Advanced Chinese Medicine, 2024, 1(1): 19-39. https://doi.org/10.1002/acm4.10

    Heart failure (HF) is a major global healthcare problem leading to substantial deterioration of prognosis. The current clinical guidelines in HF have begun to emphasize the importance of traditional Chinese medicine (TCM). TCM has been utilized in clinical practice for over 2000 years and is capable of treating a variety of HF pathogenic issues. This review summarizes the classification, pathophysiology, and treatment of HF from three perspectives: Western medicine, TCM, and integrated traditional Chinese and Western medicine (ITCWM). Emphasizing the most recent evidence, this review consolidates knowledge on ITCWM treatments for HF pertaining to different TCM syndromes, including TCM decoctions, oral patent Chinese medicine, TCM injections, as well as therapies like acupuncture and moxibustion. Additionally, this review explores TCM approaches to HF prevention, such as tai chi, Baduanjin exercise, and Sanfu acupoint herbal patching. The findings of this study suggest that ITCWM holds promise for the treatment and rehabilitation of HF. However, further research is warranted to elucidate the underlying mechanisms.

  • REVIEW ARTICLE
    Ying Luo, Jiankun Song, Le Kuai, Qi Zheng, Mingxia Wang, Guoshu Deng, Ying Zhang, Xin Li, Ruiping Wang, Bin Li
    Advanced Chinese Medicine, 2024, 1(1): 13-18. https://doi.org/10.1002/acm4.2

    Psoriasis is a kind of immune-mediated chronic skin disease induced by combined genetic and environmental factors. The effective and safe treatment of psoriasis has always been a challenge in dermatology clinics. Traditional Chinese medicine (TCM), an important direction for the current treatment of psoriasis, is characterized by historical significance, unique characteristics, and rich experience. In recent years, the “hemo-modulating therapy” of TCM has reached a consensus with excellent progress in the treatment of psoriasis. This paper reviews the current TCM treatments of psoriasis and discusses the possibilities for psoriasis disease management.

  • CASE STUDY
    Yan Zhu, Yaoshui Lai, Hongjie Song
    Advanced Chinese Medicine, 2024, 1(2): 128-135. https://doi.org/10.1002/acm4.20

    The patient was diagnosed with primary liver cancer featuring intrahepatic metastasis (Barcelona stage B; Stage IIB), hepatitis B infection, and post-hepatitis B cirrhosis during the period of compensated liver function. Following a 7-month regimen combining traditional Chinese herbal medicine (TCHM) with Renvatinib and Carrelizumab, the patient exhibited favorable tolerability, no bleeding risks, and stable tumor progression. The effectiveness of TCHM in this case was marked by significant symptom alleviation, reduced serum molecular markers, minimized adverse reactions, and obviated surgical intervention. Blood tests displayed alpha-fetoprotein levels ranging from 8.85 to 20.65 IU/mL, with no increase in bleeding risks.

  • CONSENSUS
    Qingwen Tao, Jinping Wang, Zihan Wang, Yuan Xu, Jianming Wang, Yingze Zhang
    Advanced Chinese Medicine, 2024, 1(2): 79-86. https://doi.org/10.1002/acm4.13

    The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working-age adults not yet age-eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working-age adults with a history of cancer and compare them with estimates among working-age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer.

  • RESEARCH ARTICLE
    Deshuang Yang, Jiangquan Liao, Shiyi Tao, Ziyi Sun, Li Huang, Xiang Xiao, Fang Wang, Mingjing Shao
    Advanced Chinese Medicine, 2024, 1(2): 114-127. https://doi.org/10.1002/acm4.14

    Objective: This study intends to investigate the medication patterns of traditional Chinese medicine (TCM) for the treatment of acute cardiorenal syndrome (ACRS) through clinical data mining.

    Methods: A retrospective study was conducted at China-Japan Friendship Hospital, encompassing hospitalized patients with ACSR admitted from June 1, 2013, to June 30, 2022. Patient treatment records, including TCM prescriptions, were gathered to establish a comprehensive prescription database. The prescriptions underwent analysis using the ancient and modern medical case cloud platform, incorporating the frequency, properties and flavors and channel tropism of each herbs, and clustering patterns, combination relationships, and complex network analysis of the whole.

    Results: A total of 330 prescriptions from eligible hospitalized patients were included, which totally involves 324 kinds of different herbs. The therapeutic effects primarily emphasized descending qi and eliminating turbidity, promoting diuresis and reducing swelling, drying dampness and dispelling phlegm, and promoting the ascension of Yang Qi. The properties were largely warm, netural, slightly cool and cold, with warm being predominant. The flavors were chiefly sweet, spicy, and bitter, with sweetness being the most common. The major channel tropism were the lung and spleen meridians, followed by the stomach, liver, heart, and kidney meridians. Combination analysis identified 30 pairs of combinations, with higher associations found in combinations such as Jiegeng, Huangqi, Chaihu, Baizhu, Zhimu, and Dangshen. Cluster analysis categorized high-frequency herbs into 4 groups: Gualou–Fabanxia–Chuanxiong–Chishao, Fuling–Baizhu–Zhigancao–Chenpi, Maidong–Guizhi–Huangqi–Chaihu–Shengma–Zhimu–Shanzhuyu, and Huangqi–Dangshen–Jiegeng–Chaihu–Shengma–Zhimu–Shanzhuyu. Complex network analysis revealed core prescriptions for treating ACRS, including 17 herbs.

    Conclusions: In the treatment of ACRS, TCM herbs with the properties of warm and neturality, and the flavors of sweet and spicy are commonly utilized. The prescribed herbal formulas have the effect of descending qi and eliminating turbidity, tonifying qi, activating blood and resolving stasis, resolving phlegm and promoting water.

  • METHOD
    Ying Chen, Xiang Xiao, Lin Li, Chao-Zeng Si, Hong Jiang, Ming-Jing Shao, Xiao-Yan Lu, Shu-Liang Zheng, Tian-Gu Dai, Qing He, Li Huang
    Advanced Chinese Medicine, 2024, 1(2): 96-104. https://doi.org/10.1002/acm4.12

    Coronary heart disease (CHD) poses a significant threat to human life and well-being. The presence of psycho-cardiology diseases not only exacerbates the progression of CHD but also imposes a substantial financial burden. Consequently, there is a pressing need to prioritize the prevention and management of psycho-cardiology conditions. Given the complex adverse effects associated with antidepressants, it is imperative to investigate alternative, safer, and more efficacious early interventions for psycho-cardiology diseases. The trial will randomly divide 99 patients who meet the inclusion criteria into two groups in a ratio of 1:2. Both groups will be administered standard western medicine treatment for CHD. The Qi-Shao-Tong-Mai-An-Shen (QSTMAS) group will be treated with an additional 30 mL QSTMAS herbal paste orally twice daily for up to 12 weeks. The primary endpoints are the changes of Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scores after the intervention for 12 weeks. The secondary endpoints include the scores of Traditional Chinese medicine syndromes, 6-min walking test, Insomnia severity index sleep scale, laboratory tests, and other examinations of both groups after the intervention for 12 weeks. The QSTMAS herbal paste exhibits potential and promise as a treatment modality for mild-to-moderate psychological disorders within the department of cardiology. The implementation of a rigorous trial design will facilitate an objective and scientific assessment of the clinical effectiveness and safety of combining QSTMAS herbal paste with standard western medicine for CHD patients with depression and/or anxiety. Trial Registration: China Clinical Trial Registry, ChiCTR2200065179. Registered 31 October 2022.

  • METHOD
    Xian Jin, Yanmei Wang, Ping Li, Lili Wu, Na Wang, Jun Duan, Qinyu Jiang, Yangxi Li, Zhuo Yin, Xi'ai Wu, Xiaoping Chen
    Advanced Chinese Medicine, 2024, 1(2): 105-113. https://doi.org/10.1002/acm4.19

    Background: Diabetic kidney disease (DKD) is one of the most common microvascular complications of diabetes mellitus and has become the primary cause of end-stage renal disease in China. In patients with severe renal insufficiency, Western medical treatments often yield unsatisfactory results. Preliminary studies have indicated that the Chinese herbal formula Tangshen Fang improves estimated glomerular filtration rate (eGFR) in patients with DKD.

    Methods/design: This is a multicenter, randomized, open-label, controlled clinical trial. DKD patients with eGFR levels between 25 and 75 mL/min (1.73 m2) and urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g, or eGFR level between 25 and 60 mL/min (1.73 m2) and UACR <30 mg will be included. A total of 144 participants will be randomly allocated to the treatment group (Tangshen Fang plus standard Western medicine with or without other traditional Chinese medicine [TCM]) and the control group (standard Western medicine with or without other TCM) at a 1:1 ration. The study duration will be 24 weeks and the follow-up period will be extended to 96 weeks. The primary endpoint will be the change in eGFR from baseline to week 24. Secondary endpoints will include changes in UACR, body weight, waist circumference, blood pressure, lipid levels, fasting plasma glucose, glycosylated hemoglobin A1c (HbA1c), and improvement in TCM symptoms and quality of life. Adverse events will also be evaluated.

    Discussion: This study will provide evidence of the effectiveness and safety of Tangshen Fang in treating patients with DKD. It will also form the clinical pathway and expert consensus on integrating traditional Chinese and Western medicine for DKD and provide clinical evidence for the rational use of hospital preparations of Tangshen Fang.

    Trial registration: Chinese Clinical Trials Registry, ChiCTR2300069269. Registered March 10, 2023.

  • CONSENSUS
    Qing-Wen Tao, Jing Luo, Tzu-Hua Wu, Jian-Ming Wang, Yuan Xu, Di-Er Jin
    Advanced Chinese Medicine, 2024, 1(2): 87-95. https://doi.org/10.1002/acm4.21

    Treatment integrating traditional Chinese and Western medicine for primary Sjögren's syndrome (pSS) has yielded positive results and gained wide acceptance. However, the absence of standardized clinical management in certain regions has led to suboptimal outcomes in the diagnosis and treatment of pSS in China. In response, the Center for Traditional Chinese and Western Medicine at the China-Japan Friendship Hospital, in collaboration with the Beijing Association of Traditional Chinese and Western Medicine Rheumatology Professional Committee, initiated a project led by the Traditional Chinese Medicine Department of Rheumatism. The project (Beijing Association of the Integrating of Traditional and Western Medicine standardization expert consensus record number: 2021Z031A3) aims to develop a set of quality control indicators for the integrated treatment of pSS using traditional Chinese and Western medicine. Based on the 2021 version, the consensus revision incorporates seven new items, focusing on essential assessment areas for pSS patients, treatment response, and healthcare cost management. The 2023 expert consensus update seeks to enhance pSS diagnosis and treatment practices in China, offering a benchmark for medical quality control.