Key points of post-marketing evaluation of classic traditional Chinese medicine prescriptions based on combination of disease and syndrome / 中国中药杂志

Classic prescriptions, hospital preparations and famous traditional Chinese medicine(TCM) experience prescriptions are the main sources of new drug development and innovation. The multi-components and multi-targets treatment characteristics of TCM are advantages, but at the same time, broad indications, unclear clinical positioning and lack of evidence-based evidence support are the key problems affecting the play of TCM efficacy and restricting its promotion and application. The hot in recent research was to how to break through the bottleneck, precise clinical positioning, highlight the advantages of the classic TCM prescriptions, and complete the transformation from clinical practice, clinical research to clinical evidence, but at the same time, it is also the difficulty. The clinical research model of the combination of disease and syndrome can fully reflect the ancient medical case evidence of classic TCM prescriptions, the historical experience of human used and the characteristics of syndrome differentiation and treatment, and highlight the advantages of Chinese medicine. At the same time, under the modern disease classification system and research mode, is conducive to established the standardized clinical evidence report and evaluation system, is conducive to promote the integration of clinical research evidence, and avoids excessive attenuation of information. Based on the previous work of our team, the intention of this study was to make a comment about the key points of the post-marketing evaluation of the classic TCM prescriptions under the combination of disease and syndrome and includes key points:(1)With the syndrome as the carrier, connected with the classical prescription and clinical diseases, focused on the clinical positioning on macroscopically.(2)The combination of syndrome visualization, standardization and pharmacological molecular basis, focus on clinical precise positioning in microscopic.(3)Innovating therapeutic effect evaluation methods, reflecting the curative effect characteristics based on syndrome differentiation.(4)The combination of "randomized controlled evidence-based studies" and "real world evidence-based evaluation", focusing on clinical advantages, fully evidence-based evidence.(5)Make full use of clinical registration studies and pay attention to safety.

Compatibility Rules of Prescriptions Containing Forsythiae Fructus in Dictionary of Traditional Chinese Medicine Prescriptions and Anti-inflammatory Mechanism： An Exploration Based on Data Mining and Network Pharmacology / 中国实验方剂学杂志

Objective:To analyze the compatibility rules of prescriptions containing Forsythiae Fructus based on data mining and explore the anti-inflammatory mechanism of Forsythiae Fructus based on network pharmacology，so as to provide reference for the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines. Method:The prescriptions containing Forsythiae Fructus in the<italic> Dictionary of Traditional Chinese Medicine Prescriptions</italic> were collected，based on which a clinical prescription database was constructed. The Chinese herbs combined with Forsythiae Fructus and the corresponding indications were subjected to frequency statistics，association rule analysis，and complex network analysis using SPSS Statistics 26，IBM SPSS Modeler 18.0，and Gephi 9.2. The active components and targets of Forsythiae Fructus for anti-inflammation were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），BATMAN-TCM，and SEA，and the targets related to anti-inflammation from GeneCards，Online Mendelian Inheritance in Man （OMIM），CTD，and GenCLiP3. Following the analysis of protein-protein interactions （PPI） with STRING，a PPI network was constructed. The enrichment analysis was performed using Metascape，and the active component-anti-inflammation target-signaling pathway network of Forsythiae Fructus was constructed by Cytoscape 3.8.2. Result:According to the inclusion and exclusion criteria，2 245 prescriptions containing Forsythiae Fructus were harvested，involving 512 Chinese herbs，with a total usage frequency of 27 314. The Chinese herbs that were most frequently combined with Forsythiae Fructus （>800 times） were Glycyrrhizae Radix et Rhizoma （1 483 times），Scutellariae Radix （964 times），and Angelicae Sinensis Radix （842 times）. Hence，the herbal pairs "Forsythiae Fructus-Scutellariae Radix" and "Forsythiae Fructus-Angelicae Sinensis Radix" were further explored. The prescriptions containing Forsythiae Fructus could be utilized for the treatment of 29 kinds of diseases，and three representative disease categories including "carbuncle，gangrene，sores and ulcers"，"ophthalmic diseases and syndromes" and "epidemic diseases" are selected for data mining. There were 19 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Lonicerae Japonicae Flos-Angelicae Sinensis Radix" as the core herb combination for "carbuncle，gangrene，sores and ulcers". The clustering analysis revealed one multi-herb clustering group，four herbal pairs，and single herb Lonicerae Japonicae Flos，the complex network analysis four herbal modules，and the factor analysis six common factors. There were 23 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Scutellariae Radix-Angelicae Sinensis Radix" as the core herb combination for "ophthalmic diseases and syndromes". The clustering analysis revealed two multi-herb clustering groups and four herbal pairs，the complex network analysis four herbal modules，and the factor analysis five common factors. There were 28 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Menthae Haplocalycis Herba-Lonicerae Japonicae Flos" as the core herb combination for "epidemic diseases". The clustering analysis revealed three multi-herb clustering groups，one herbal pair，and two single herbs Forsythiae Fructus and Glycyrrhizae Radix et Rhizoma，the complex network analysis four herbal modules，and the factor analysis five common factors. As demonstrated by network pharmacology-based analysis，the core anti-inflammation components of Forsythiae Fructus were quercetin，luteolin，and kaempferol，and the core targets were phosphoinositide-3-kinase regulatory subunit 1 （PIK3R1），protein kinase B 1 （Akt1），and epidermal growth factor receptor（EGFR）. The biological pathways were mainly concentrated in proteoglycans in cancer，pathways in cancer，and PI3K/Akt signaling pathway，with such functions as inhibition of transcription factors，regulation of enzyme activity，and inflammation-related gene expression involved. Conclusion:This study employed a variety of data mining techniques to objectively，intuitively，and scientifically uncover the compatibility rules of Forsythiae Fructus in the treatment of high-frequency diseases. It has been found that Forsythiae Fructus is often combined with heat-clearing herbs，tonifying herbs，exterior-releasing herbs，and blood-activating and stasis-resolving herbs for diverse diseases and syndromes. Under the premise of clearing heat and removing toxin，reinforcing healthy Qi and dredging stagnation are also emphasized. According to the degree of internal heat exuberance，the heat-clearing herbs with different merits are combined. This study has revealed the unique advantages of Forsythiae Fructus in the treatment of specific diseases and syndromes as well as its multi-component，multi-target，and multi-pathway mechanisms in anti-inflammation，breaking through the limitations in modern clinical and experimental research of Forsythiae Fructus. These findings are of great significance for guiding the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines，thus better accelerating the development of Chinese medicine health industry.

Analysis of medication regularity of traditional Chinese medicine prescriptions for gastropyretic excessiveness diabetes based on data mining / 中国中药杂志

To analyze the medication regularity of traditional Chinese medicine(TCM) prescriptions for gastropyretic excessiveness diabetes recorded in Chinese Medicine Prescriptions Dictionary. A total of 103 eligible prescriptions were input into the system platform, and the Apriori algorithm was used to analyze their medication regularity. The 103 prescriptions for gastropyretic excessiveness diabetes were selected from the system, and 29 herb medicines were found with frequency of usage more than 8. Totally 33 commonly used herbal pairs(support degree≥10), twenty-three 3-herb core combinations(support degree≥8, confidence values≥0.5), and twenty-one 4-herb core combinations(confidence values≥0.5) were discovered after the medication regularity analysis by Apriori algorithm. The herbal medicine combinations with the highest correlation degree were discovered after the association rule analysis on the 103 prescriptions(support degree≥10, confidence values≥0.5). The four properties, five tastes, channel distributions and frequency of dose of the 103 prescriptions were also obtained after the corresponding analysis. According to the analysis and summary of the above data, the combination of Trichosanthis Radix, Anemarrhenae Rhizoma, Coptidis Rhizoma and Ophiopogonis Radix could reflect the medication regularity of TCM prescriptions for gastropyretic excessiveness diabetes to a certain degree, which is of great significance in guiding value in clinic.

Discussion and research progress in standard decoction of medicinal slices / 中国中药杂志

Standard decoction of medicinal slices has gradually acquired the height of researcher,government and enterprise for approval. And much consensus are increasingly reached. But there are lots of problem needing further discussing.This article summaries the published literature about standard decoction of medicinal slices in recent 3 years. And clarifies the origin of standard decoction of medicinal slices,explain the definition. The study status of standard decoction was reviewed and further analyzed in detail. And then the application fields of standard decoction of medicinal slices are listed. Combined with the research examples of groups,the problem in the study of standard decoction of medicinal slices was discussed. And relevant suggestions are put forward. All this is expected to provide reference in standard decoction research,the quality criterion o of formula granule and study of classical traditional Chinese medicine( TCM) excellent prescriptions.

Study on relevance mining of "core drug action target" in Dictionary of Traditional Chinese Medicine Prescriptions / 中国中药杂志

Based on the database of "Dictionary of Traditional Chinese Medicine Prescriptions", high-frequency herbs of Xiaoke disease is mined by traditional Chinese medicine inheritance support system, and core herbs and combinations are discovered through association rules and cluster analysis. On this basis, based on the integrative pharmacology of traditional Chinese medicine to explore the herb-disease relationship, the "herb-compound-target" network is constructed and enriched for the analysis of key target gene functions, metabolic pathways, and their "core herb-target interactions". In order to explore the molecular mechanism of its prevention and treatment of diabetes, 341 diabetes prescriptions are collected, organized, and tapped in the Dictionary of Traditional Chinese Medicine Prescriptions. Herb frequency statistics show that Licorice was the most commonly used, followed by Ophiopogonis Radix, Poria, Ginseng Radix et Rhizoma, Coptidis Rhizoma, etc., the medicinal properties are mostly cold, warm and ping, and the medicinal taste tends to be pungent, bitter, and sour, and they were attributed to lung meridian, stomach meridian, spleen meridian, etc. Among them, the 17 herbs were closely related. Ginseng Radix et Rhizoma, Ophiopogonis Radix, Poria and Glycyrrhizae Radix et Rhizoma were the core Chinese herbs. Ophiopogonis Radix was the key node of Coptidis Rhizoma, Trichosanthis Radix and core Chinese medicine, and Ophiopogonis Radix was the key node for the connection between Coptidis Rhizoma and Trichosanthis Radix and the core Chinese herbs. Using integrated pharmacology platform analysis, 10 crucial core targets for the prevention and treatment of diabetes were obtained, including the known disease targets (PLCD1, PIK3R1, ENPP1), and potential herb targets(GNB1, ADCY1, AKT1, RAC1, PRKAA1, RHOA) , common target (GCK). There were seven similar targets in the 10 crucial core targets predicted with the combination of "Ophiopogonis Radix, Coptidis Rhizoma and Trichosanthis Radix", including PLCD1, PIK3R1, ENPP1, ADCY1, AKT1, PRKAA1, GCK. These genes were mainly located in the cytosol, plasma membrane, etc., involved in adenosine triphosphate binding, protein binding, platelet activation, etc., mainly involved in the endocrine system, signal transduction, chemokine signaling pathway, cancer pathway, and other metabolic pathways, and it is speculated that these genes were potentially associated with diabetes. In this study, Traditional Chinese Medicine Inheritance Support System and Integrative Pharmacology of Traditional Chinese Medicine are used to analyze the prescription law of Xiaoke prescription, and the correlation of "core herbs-functionary targets" is excavated, which provided the basis and reference for the screening and development of TCM prescriptions for the prevention and treatment of diabetes.

A clustering method of Chinese medicine prescriptions based on modified firefly algorithm / 中国结合医学杂志

This paper is aimed to study the clustering method for Chinese medicine (CM) medical cases. The traditional K-means clustering algorithm had shortcomings such as dependence of results on the selection of initial value, trapping in local optimum when processing prescriptions form CM medical cases. Therefore, a new clustering method based on the collaboration of firefly algorithm and simulated annealing algorithm was proposed. This algorithm dynamically determined the iteration of firefly algorithm and simulates sampling of annealing algorithm by fitness changes, and increased the diversity of swarm through expansion of the scope of the sudden jump, thereby effectively avoiding premature problem. The results from confirmatory experiments for CM medical cases suggested that, comparing with traditional K-means clustering algorithms, this method was greatly improved in the individual diversity and the obtained clustering results, the computing results from this method had a certain reference value for cluster analysis on CM prescriptions.

Analysis on composition principles of formulae containing Gardeniae Fructus in dictionary of traditional Chinese medicine prescriptions / 中国中药杂志

Gardeniae Fructus, which is widely used in health foods and clinical medicines, is a type of edible food and medicine. Dictionary of traditional Chinese medicine prescriptions provides good materials for prescription analysis and the R&D of traditional Chinese medicines. The composition regularity of formulae containing Gardeniae Fructus in dictionary of traditional Chinese medicine prescriptions was analyzed on the basis of the traditional Chinese medicine inheritance support system(TCMISS), in order to provide reference for clinical application and the R&D of new drugs. TCMISS was applied to establish a database of prescriptions containing Gardeniae Fructus. The software's frequency statistics and association rules and other date mining technologies were adopted to analyze commonly used drugs, combination rules and core combined formulae containing Gardeniae Fructus. Totally 3 523 prescriptions were included in this study and involved 1 725 Chinese herbs. With a support degree of 352(10%) and confidence coefficient of 90%, 57 most commonly used drug combinations were screened. Drugs adopted in core combinations were relatively concentrated and selected according to definite composition methods. They were used to mainly treat 18 diseases. Gardeniae Fructus have often been combined with herbs for heat-clearing and detoxification, expelling pathogenic wind, relieving exterior syndrome, invigorating the circulation of blood and gas and promoting blood circulation for removing blood stasis to mainly treat jaundice, typhoid, headache and other syndromes.

A prescrição medicamentosa ambulatorial no internato: formação e prática / Outpatient prescriptions by medical interns: training and practice

A prescrição correta de medicamentos é tema de extrema relevância na resolutividade dos problemas da saúde. Frente às deficiências constatadas, a Organização Mundial da Saúde incluiu entre seus objetivos o aprimoramento do ensino da farmacoterapia para estudantes de Medicina. Neste contexto, o presente trabalho avalia a prescrição ambulatorial dos alunos do internato do curso de Medicina da Universidade Federal de Alagoas, bem como o processo de formação para a sua elaboração. Trata-se de um estudo transversal e descritivo, que realizou a análise documental de 133 prescrições de medica mentos em situações de simulação e de 67 questionários. Concluiu-se que o assunto não integra o cur rículo formal do curso de maneira explícita e que as deficiências detectadas com relação às prescrições são semelhantes às encontradas na literatura referentes a profissionais graduados. Nas condutas dos alunos, ressaltou-se a preocupação com a adesão ao tratamento, a prioridade dada ao uso de medica mentos genéricos, a seleção dos produtos de acordo com o nível socioeconômico dos pacientes, além do interesse e empenho na prescrição. Evidenciou-se a relevância do ensino da forma correta da prescrição medicamentosa na graduação médica.

Appropriate medical prescription is extremely important for solving health problems. Given wides pread problems with medical prescriptions, the World Health Organization's objectives now include improving the teaching of pharmacotherapy in medical schools. Within this context, the current study analyzes outpatient prescriptions by medical interns at the Federal University in Alagoas, as well as the related training process. This was a cross-sectional and descriptive study including a document analysis of 133 drug prescriptions in simulated situations and 67 questionnaires. The study con cluded that the subject is not explicitly included in the formal medical school curriculum, and that the flaws identified were similar to those reported in the literature for medical school graduates. The students' conduct highlighted their concern with patient adherence, the priority in the use of generic drugs, product selection in keeping with patients' socioeconomic status, and interest and dedication in the prescription process. The study showed the relevance of proper teaching of drug prescription during undergraduate medical training.

Experimental research on Chinese herbal prescriptions to treat rheumatoid arthritis and their anti-inflammatory mechanism / 中国免疫学杂志

Objective:To investigate the effects of Chinese medicine prescriptions Gancaofuzi-tang and Tongbi-fang on adjusting the dynamic expression of related cytokines and further ameliorating the histopathology of synovitis in rats with Ⅱ collagen induced arthritis(CIA).Methods:The experimental Wistar rat model of CIA was set up successfully.The rats divided into five groups in random: normal(N),Gancaofuzi-tang treatment(GF),Tongbi-fang treatment(TB),Puwei western medicine treatment(PW) and model control(C).The different medicine was affused into stomach 1.5 ml/rat,once daily.The rats were sacrificed after 6 weeks of medicine administration.Foot swelling degrees of the rats were measured every other day,and then calculate swelling rates.Getting blood after 3 weeks of treatment from rat's innercanthus to detect the level of serum Sialic Acid(SA) and the level of serum IL-2 and TNF-? by ELISA.The synovial histopathology was observed with HE staining under optical microscope.Results:Gancaofuzi-tang and Tongbi-fang significantly decreased swelling rate of joints in CIA rats.The pathology of synovisl tissues was markedly ameliorated.After administration for 3 weeks,the levels of serum SA,IL-2 and TNF-? of the rats in GF and TB groups were significantly decreased compared with the control.Continuous administration for 6 weeks,the levels of the targets in GF and TB rats reached to near the normal level.Conclusion:All the results demonstrate that Gancaofuzi-tang and Tongbi-fang play anti-inflammatory and immunoregulatory roles in CIA rats through inhibiting activation of some inflammatory mediators,adjusting related cytokines expression,then eliminating the joint swelling and improving synovitis pathology,which might be looked as immune suppression effects similar to NSAID medicine.