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Abbreviations ANCOVA: Analysis of covariance; ASAS: Assessment of Spondyloarthritis International Society; ASQoL: Ankylosing Spondylitis Quality of Life; AxSpA: Axial spondyloarthritis; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; BASFI: Bath Ankylosing Spondylitis Functional Index; BASG: Bath Ankylosing Spondylitis Global score; CONSORT: Consolidated Standards of Reporting Trials; DMARD: Disease-modifying antirheumatic drug; ITT: Intention to treat; MTX: Methotrexate; NRS: Numerical rating scale; NSAID: Non-steroidal anti-inflammatory drug; OMERACT: Outcome Measures in Rheumatology; PRECIS-2: Pragmatic Explanatory Continuum Indicator Summary Framework-2; QOL: Quality of life; REDCap: Research Electronic Data Capture; SF-36: 36-item Short Form Health Survey; SF6D: ShortForm Six-Dimension; SPIRIT: Standard Protocol Items: Recommendations for Interventional Trials; SSZ: Sulfasalazine; STRICTA: Standards for Reporting Interventions in Clinical Trials of Acupuncture; TCM: Traditional Chinese medicine; TCMCMC: Traditional Chinese medicine collaborative model of care
Source publication
Background
Axial spondyloarthritis (AxSpA) is a chronic disease which results in fatigue, pain, and reduced quality of life (QoL). Traditional Chinese medicine (TCM), especially acupuncture, has shown promise in managing pain. Although a TCM collaborative model of care (TCMCMC) has been studied in cancer, there are no randomized controlled trials i...
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Background
Sciatica is a relatively frequent illness that easily becomes a chronic and relapsing condition. Although numerous systematic reviews have analyzed various therapies for sciatica, the validity of their included studies is limited. Considering the limitations of conventional treatment options for sciatica, acupuncture is a possible option...
Citations
... Closed fracture in traditional Chinese medicine can be ascribed to "bone broken tendon injury" category, its pathogenesis is roughly qi and blood not free, blood stasis block, meridians and muscles and bones are damaged to cause pain, swelling. Therefore, the treatment should be based on activating qi to relieve pain, activating blood circulation to remove blood stasis and replenish bones, and regulating qi [6]. Traditional Chinese medicine compound refers to a prescription made of at least two Chinese herbs, which has relatively prescriptive processing methods and usage methods [7]. ...
Objective To assess weather the external application of traditional Chinese medicine can promote the trabecular bone regeneration and callus fibrous transformation by regulating IL-1, BMP2, TNF-α, TGF and other serum biochemical index AKP.
Methods By constructing a rabbit model of closed fracture, the effects of different stages of external application of traditional Chinese medicine on inflammatory factors, serum biochemical indexes and bone marrow morphology were observed..
Results The expressions of inflammatory factors IL-1 and TNF-α in the closed fracture model after external application of traditional Chinese medicine 1, 2, 3 and positive drug treatment were significantly decreased (P < 0.05). The results of HE staining showed that after the 1, 2 and 3 stage of external application of traditional Chinese medicine and the positive drug treatment, new bone trabeculae grew into the bone marrow cavity, granulation tissue formed at the fracture end, and the original callus formed part of the area transformed into fibrous callus. The results of immunohistochemistry showed that the levels of BMP2, TGF and FGF increased during the treatment of bone marrow neogenesis with external application of traditional Chinese medicines in phases 1, 2 and 3 and positive drugs. (P < 0.05). X-ray results showed that the radial fracture line disappeared and gradually recovered after the treatment of Chinese medicine 1, 2, 3 and positive medicine.
Conclusion External application of traditional Chinese medicine can promote trabecular bone regeneration and callus fibrous transformation by regulating inflammatory factors IL-1 and TNF-α, serum biochemical index AKP, and regulating the expression of BMP2, TGF and FGF levels.
... Therefore, we are conducting an RCT that aims to evaluate the effectiveness of a TCM collaborative model of care (TCMCMC) involving acupuncture for patients with axSpA. 8 However, quantitative research alone cannot thoroughly provide a full understanding of the feasibility of the TCMCMC. 9 Thus, this qualitative study nested within the RCT aimed to explore participants' perceptions of the feasibility of the TCMCMC, specifically the facilitators of and barriers to implementing a TCMCMC involving acupuncture for patients with axSpA. ...
... Details of the RCT can be found in the protocol. 8 Briefly, we recruited patients with active axSpA with inadequate response to NSAIDs, who did not receive biologic treatment within the 3 months prior to the point of recruitment. The recruited patients were randomised into either the collaborative care (intervention) arm or the usual care (control) arm. ...
Background
Conventional therapy may be inadequate for many patients with axial spondyloarthritis (axSpA). Traditional Chinese medicine (TCM) may be a viable alternative, but its effectiveness for axSpA is unknown. We are currently conducting a pragmatic randomised controlled trial (RCT) to investigate the effectiveness of a TCM collaborative model of care (TCMCMC), which combines usual rheumatologic care with acupuncture for patients with axSpA. This nested qualitative sub-study aims to identify facilitators of and barriers to the implementation of the TCMCMC.
Methods
We conducted individual in-depth interviews with participants who had completed the acupuncture regimen to elicit opinions on the facilitators of and barriers to the implementation of the TCMCMC. The interviews were transcribed and analysed using thematic analysis.
Results
Twelve participants were included, with data saturation occurring after 10 interviews. The analysis revealed both a number of important ‘facilitators’ and ‘barriers’. Facilitators to the implementation of the TCMCMC included effectiveness of TCM to relieve symptoms, inadequacy of conventional treatment and positive social perceptions of TCM. Barriers included scepticism towards TCM, inability of TCM to provide instant relief, needle-related discomfort, variable effectiveness of TCM influenced by physicians’ skills and experience and the high cost of TCM. Recommendations to overcome barriers included further patient education about TCM.
Conclusion
Policymakers should take into account the various feasibility factors identified in this study when developing and implementing a TCMCMC.
Trial registration number
NCT03420404 (ClinicalTrials.gov)
Background and Objective: Severe pneumonia is a critical respiratory disease with high mortality. There is insufficient evidence on the efficacy and safety of traditional Chinese medicine (TCM) adjuvant therapy for severe pneumonia. This study aims to identify, describe, assess, and summarize the currently available high-quality design evidence on TCM adjuvant therapy for severe pneumonia to identify evidence gaps using the evidence mapping approach.
Methods: Systematic searches were performed on English and Chinese online databases (PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, WanFang Data, CQVIP, and SinoMed) to identify papers from inception until August 2023 for inclusion into the review. Randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses concerning TCM adjuvant therapy for severe pneumonia or its complications in adults were included. The risk of bias in RCTs was evaluated by using the Cochrane Handbook ROB tool. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Review (ROBIS) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, risk of bias, and evidence quality of SRs or meta-analyses, respectively. Then, a bubble plot was designed to visually display information in four dimensions.
Results: A total of 354 RCTs and 17 SRs or meta-analyses met the inclusion criteria. The published RCTs had several flaws, such as unreasonable design, limited sample size, insufficient attention to non-drug therapy studies and syndrome differentiation, improper selection or use of outcome indicators, and failure to provide high-quality evidence. Sixteen SRs or meta-analyses of methodological quality scored “Critically Low” confidence. Twelve SRs or meta-analyses were rated as “High Risk.” Most outcomes were rated as “Low” evidence quality. We found that TCM combined with conventional treatment could improve the clinical total effective rate and the TCM syndromes efficacy. The combined approach could also shorten mechanical ventilation time, infection control time, and length of hospital and ICU stay; significantly reduce temperature, respiratory rate, heart rate, white blood cell counts, levels of C-reactive protein, procalcitonin, blood inflammatory factors, bacteriological response, and D-dimer; decrease CPIS, APACHE II score, and PSI score; improve pulmonary imaging features, arterial blood gas indicators (including arterial oxygen pressure, arterial oxygen saturation, and oxygen index), and lung function (including forced vital capacity and forced expiratory volume in the first second) for severe pneumonia compared with conventional treatment only ( p < 0.05). There was no significant difference in adverse reactions and incidence of adverse events ( p > 0.05). In addition, compared with conventional treatment only, most SRs or meta-analyses concluded that TCM combined with conventional treatment was “Beneficial” or “Probably beneficial.”
Conclusion: TCM combined with conventional treatment had advantages in efficacy, clinical signs, laboratory results, and life quality outcomes of severe pneumonia, with no difference in safety outcomes compared with conventional treatment only. QingJin Huatan decoction is the most promising target, and Xuanbai Chengqi decoction has a “Probably beneficial” conclusion. XueBiJing injection and TanReQing injection are two commonly used Chinese herbal injections for treating severe pneumonia, and both are “Probably beneficial.” However, there was a need for multicenter RCTs with large sample sizes and high methodological quality in the future. In addition, the methodological design and quality of SRs or meta-analyses should be improved to form high-quality, evidence-based medical evidence and provide evidence for the effectiveness and safety of TCM adjuvant therapy for severe pneumonia.
