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欧盟监管环境视角下的传统医药全球化 Perspective

Werner Knoess, Jacqueline Wiesner

《工程（英文）》 2019年 第5卷 第1期   页码 22-31 doi: 10.1016/j.eng.2018.11.012

摘要：

欧盟（EU）成员国对于医药产品已经进行了统一立法，其中明确定义了草药产品和传统草药产品。目的是建立一个考虑到草药产品特殊性的监管环境。统一标准旨在协调评估并促进不同成员国进入市场。欧盟草药产品委员会（HMPC）的欧盟草药专论定义的标准和《欧洲药典》规定的质量要求代表了草药和传统药物监管环境多国协调的优秀模式。此外，该框架至少部分适用于包含于中药（TCM）中的中草药和传统药物，以便进入欧盟市场。此外，HMPC还就中草药安全性和有效性的专论提供了具体的指导文件和试点项目。在《欧洲药典》中，与中药相关的草药质量的专论数量不断增加。这些发展表明与中药相关的全球化是一个持续的过程。相关监管机构、科学界和感兴趣的利益相关者之间的沟通与合作将为各种监管环境的融合奠定基础。这将有助于在适当标准的基础上在世界范围内运用传统药物。

关键词： 传统医药     中药     欧盟草药产品委员会     草药     传统医药     规范     全球化    

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中药生物活性成分对糖脂代谢紊乱疾病的治疗作用和机制 Review

张莹, 鞠佳明, 焦磊, 杨宝峰

《工程（英文）》 2023年 第29卷 第10期   页码 73-82 doi: 10.1016/j.eng.2023.03.004

摘要：

胆固醇和葡萄糖稳态异常在心血管疾病、脑血管疾病、中枢神经系统疾病和癌症等多种疾病的发生发展中起着至关重要的作用。 越来越多的研究表明，体内脂肪堆积过多与2型糖尿病或胰岛素抵抗有关，高胆固醇和高血糖将加重上述疾病的发展进程。因此，稳定患者的血脂和血糖水平是改善心脑血管和中枢神经系统疾病患者症状的主要策略。中药（CHM）在中国已有两千多年的历史，建立了独特的中医理论，积累了丰富的临床经验。此外，中药在国内外广泛应用于心脑血管疾病的治疗和预防，具有防治高脂血症、糖尿病和高血压等疾病的优势。然而，中药在西方国家的使用仍然相当有限，部分原因是对其多种复杂成分的了解不完整，药理机制不确定。本文就中药生物活性成分及其制剂治疗高脂血症和高血糖症的作用、分子机制和临床研究进展进行综述和讨论。

关键词： Chinese herbal medicines     Hyperlipidemia     Hyperglycemia     Cardiovascular and cerebrovascular diseases    

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中草药在水产养殖中的应用研究进展

蒲红宇, 李晓宇, 杜青波, 崔昊, 徐永平

《工程（英文）》 2017年 第3卷 第5期   页码 731-737 doi: 10.1016/J.ENG.2017.03.017

摘要：

随着人们对水产食品安全关注的不断加强，越来越多的化学合成药物在水产养殖中被禁用。同时，由于中草药具有绿色天然的优点，近年来其在水产养殖领域被广泛应用。研究表明，中草药具有促进养殖鱼类生长、提高抗病力、改善肌肉品质等多方面的作用。中草药所含生物活性物质不仅能够增加鱼类摄食量和消化酶活性，而且可能影响养殖产品风味。许多中草药种类还能够显著提升养殖鱼类的特异性和非特异性免疫力。然而，由于中草药的植物成分非常复杂，有效地分离提纯药用成分是开发应用的关键。本文回顾了中草药关于生长表现和饲料利用，免疫和抗病力以及养殖产品质量方面的最新研究和应用进展。本文同时介绍了中药材化学成分研究的新技术和方法，分析了中草药在水产养殖应用方面存在的问题，认为未来中草药研究应重点关注如何经济地提炼有效成分以及最佳的用药途径。

关键词： 水产养殖     中草药     渔业     研究进展    

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A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 432-439 doi: 10.1007/s11684-017-0511-1

摘要：

Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment. However, because of the lack of knowledge on traditional Chinese patent medicines, many Western physicians, who are accountable for the majority of clinical prescriptions for such medicine, are confused with the use of traditional Chinese patent medicines. Therefore, the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines. In this paper, Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment. First, 115 stroke patients from three hospitals are recruited in the cross-sectional survey. Simultaneously, traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient. Second, particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment. Moreover, these particular indicators can be easily obtained by Western physicians and are feasible for widespread clinical application in the future. Third, the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking. Experimental results reveal that traditional Chinese patent medicines can be differentiated. Moreover, the proposed model can obtain high accuracy of aid decision.

关键词： traditional Chinese patent medicines     stroke     aid decision     data mining     manifold ranking    

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Lingguizhugan Decoction, a Chinese herbal formula, improves insulin resistance in overweight/obese subjects

《医学前沿（英文）》 2022年 第16卷 第5期   页码 745-759 doi: 10.1007/s11684-021-0880-3

摘要： Lingguizhugan Decoction (LGZG) has been investigated in basic studies, with satisfactory effects on insulin resistance in non-alcoholic fatty liver disease (NAFLD). This translational approach aimed to explore the effect and underlying mechanism of LGZG in clinical setting. A randomized, double-blinded, placebo-controlled trial was performed. A total of 243 eligible participants with NAFLD were equally allocated to receive LGZG (two groups: standard dose and low dose) or placebo for 12 weeks on the basis of lifestyle modifications. The primary efficacy variable was homeostasis model assessment of insulin resistance (HOMA-IR). Analyses were performed in two populations in accordance with body mass index (BMI; overweight/obese, BMI ≥ 24 kg/m2; lean, BMI < 24 kg/m 2). For overweight/obese participants, low-dose LGZG significantly decreased their HOMA-IR level compared with placebo (−0.19 (1.47) versus 0.08 (1.99),P = 0.038). For lean subjects, neither dose of LGZG showed a superior effect compared with placebo. Methylated DNA immunoprecipitation sequencing and real-time qPCR found that the DNA N6-methyladenine modification levels of protein phosphatase 1 regulatory subunit 3A (PPP1R3A) and autophagy related 3 (ATG3) significantly increased after LGZG intervention in overweight/obese population. Low-dose LGZG effectively improved insulin resistance in overweight/obese subjects with NAFLD. The underlying mechanism may be related to the regulation of DNA N6-methyladenine modification of PPP1R3A and ATG3. Lean subjects may not be a targeted population for LGZG.

关键词： insulin resistance     non-alcoholic fatty liver disease     Chinese herbal medicine     randomized controlled trial     DNA N6-methyladenine modification    

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从天然产物创制新药的发展趋势

于德泉

《中国工程科学》 1999年 第1卷 第2期   页码 87-90

摘要：

文章展望了从天然产物中创制新药的发展趋势。单味中草药有效成分的研究重点将转向瞄准质控的中药复方化学成分研究。进入21世纪，中国天然药物研究要在国际上占有重要位置，突破口便是中药复方现代化，其关键之一便是化学（有效）成分研究。从中草药中发现有效成分或先导物必须采用化学成分与生物活性研究融为一体的机制，采用高通量筛选，目标就是寻找有效成分或先导物进而创制新药。长短结合，正确处理知识创新和新药开发的关系。知识创新须体现在创制新药的应用基础研究中，是产生巨大效益的理论基础；短程开发是知识累积水平的体现，是科研经费的必要补充和保证。改革传统天然产物化学研究模式，实施以当代最先进大型谱仪为先导的天然产物研究战略。

关键词： 天然产物     创制新药     中草药化学成分     波谱技术     高效色谱与质谱联用     高效色谱与核磁共振联用    

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Innovative development path of ethnomedicines: an overview of ethnomedicines in China

null

《医学前沿（英文）》 2016年 第10卷 第2期   页码 166-177 doi: 10.1007/s11684-016-0448-9

摘要：

In the long history of disease prevention and treatment, ancestral populations worldwide have gained knowledge and experiences in traditional medicines. For instance, ethnomedicines of Chinese ethnic minorities constitute an important part of traditional medicines. In our study, we firstly clarified the concept of ethnomedicines and the connotations of ethnopharmacology. The particularity of ethnomedicine research were then summed up, and the development profiles of the ethnomedicines of Chinese ethnic minorities were discussed by investigating the current status and existing problems. On this basis, we abstracted the innovative development path of ethnomedicines for the first time, which was found to follows:resource study → standardized development research → industrialization of the achievements and efforts for internationalization. We found that platform establishment and team training are keys to achieving innovative development. Hence, this study provided a basis for ethnomedicine development.

关键词： traditional medicines     ethnomedicines     Chinese ethnic minorities     ethnopharmacology     research mode     innovative development path    

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中药治疗新冠病毒肺炎的科学基础 Perspective

梁丽娴, 潘胡丹, 黄虞枫, 范星星, 王婉莹, 何芳, 蔡俊, 周华, 刘良

《工程（英文）》 2020年 第6卷 第10期   页码 1099-1107 doi: 10.1016/j.eng.2020.08.009

摘要：

新近暴发的新冠病毒肺炎（COVID-19）已成为危害全球健康的紧急事件。现有证据表明，新冠病毒（SARS-CoV-2）与其他冠状病毒（如SARS-CoV和MERS-CoV）的基因序列具有相似性。因此， 针对现存冠状病毒的引发疾病的机制研究和在治疗SARS时所取得的经验和教训，可咨今天对抗新冠病毒引发疾病的参考。COVID-19患者的临床病理特征提示患者在病情进展过程中通常会经历五个发展阶段：大量病毒感染、免疫系统抑制、细胞因子风暴、多器官损伤及后期的肺纤维化样改变， 严重者常导致死亡。早期阻断疾病进展是取得治疗成功的关键。但是，目前尚无针对COVID-19的 特效药物或疫苗，世界卫生组织（WHO）正敦促尽快建立新型预防和治疗策略。传统中医药（TCM） 对于疫病的防治的实践已经积累了几千年的有用经验，它通过整体调节机体功能发挥疗效。在此次疫情中，中医药作为替代治疗或与西药联合使用，在疫情防控中发挥了重要的作用。本文总结了此次抗疫过程中中国国家和省级机构推荐使用的中药复方和中成药的潜在用途和治疗机制，以期发现其治疗COVID-19的潜在科学内涵。同时，整合应用多种组学及转化医学技术开展基础与临床研究有望进一步证实中药复方的治疗机制。

关键词： COVID-19     SARS-CoV-2     中药     抗病毒     细胞因子风暴     肺纤维化    

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The role played by traditional Chinese medicine in preventing and treating COVID-19 in China

Qingwei Li, Han Wang, Xiuyang Li, Yujiao Zheng, Yu Wei, Pei Zhang, Qiyou Ding, Jiaran Lin, Shuang Tang, Yikun Zhao, Linhua Zhao, Xiaolin Tong

《医学前沿（英文）》 2020年 第14卷 第5期   页码 681-688 doi: 10.1007/s11684-020-0801-x

摘要： Traditional Chinese medicine (TCM), an ancient system of alternative medicine, played an active role in the prevention and control of COVID-19 in China. It improved the clinical symptoms of patients, reduced the mortality rate, improved the recovery rate, and effectively relieved the operating pressure on the national medical system during critical conditions. In light of the current global pandemic, TCM-related measures might open up a new channel in the control of COVID-19 in other countries and regions. Here, we summarize the TCM-related measures that were widely used in China, including TCM guidelines, the Wuchang pattern, mobile cabin hospitals, integrated treatment of TCM and modern medicine for critical patients, and non-medicine therapy for convalescent patients, and describe how TCM effectively treated patients afflicted with the COVID-19. Effective TCM therapies could, therefore, be recommended and practiced based on the existing medical evidence from increased scientific studies.

关键词： traditional Chinese medicine     COVID-19     Wuchang pattern     mobile cabin hospital     convalescent patients     three formulae and three medicines    

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Chinese herbal medicine reduces mortality in patients with severe and critical coronavirus disease 2019

Guohua Chen, Wen Su, Jiayao Yang, Dan Luo, Ping Xia, Wen Jia, Xiuyang Li, Chuan Wang, Suping Lang, Qingbin Meng, Ying Zhang, Yuhe Ke, An Fan, Shuo Yang, Yujiao Zheng, Xuepeng Fan, Jie Qiao, Fengmei Lian, Li Wei, Xiaolin Tong

《医学前沿（英文）》 2020年 第14卷 第6期   页码 752-759 doi: 10.1007/s11684-020-0813-6

摘要： This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076–0.418; <0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023–1.084; <0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028–0.143; <0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

关键词： COVID-19     CHM     mortality     a retrospective cohort study    

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Symptom network topological features predict the effectiveness of herbal treatment for pediatric cough

Mengxue Huang, Jingjing Wang, Runshun Zhang, Zhuying Ni, Xiaoying Liu, Wenwen Liu, Weilian Kong, Yao Chen, Tiantian Huang, Guihua Li, Dan Wei, Jianzhong Liu, Xuezhong Zhou

《医学前沿（英文）》 2020年 第14卷 第3期   页码 357-367 doi: 10.1007/s11684-019-0699-3

摘要： Pediatric cough is a heterogeneous condition in terms of symptoms and the underlying disease mechanisms. Symptom phenotypes hold complicated interactions between each other to form an intricate network structure. This study aims to investigate whether the network structure of pediatric cough symptoms is associated with the prognosis and outcome of patients. A total of 384 cases were derived from the electronic medical records of a highly experienced traditional Chinese medicine (TCM) physician. The data were divided into two groups according to the therapeutic effect, namely, an invalid group (group A with 40 cases of poor efficacy) and a valid group (group B with 344 cases of good efficacy). Several well-established analysis methods, namely, statistical test, correlation analysis, and complex network analysis, were used to analyze the data. This study reports that symptom networks of patients with pediatric cough are related to the effectiveness of treatment: a dense network of symptoms is associated with great difficulty in treatment. Interventions with the most different symptoms in the symptom network may have improved therapeutic effects.

关键词： pediatric cough     complex network     symptoms     traditional Chinese medicine     electronic medical records    

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肠道微生态——探索中药临床疗效的新思路 Review

陆艳蒙, 谢娇娇, 彭聪高, 王保红, 王恺岑, 李兰娟

《工程（英文）》 2019年 第5卷 第1期   页码 40-49 doi: 10.1016/j.eng.2018.11.013

摘要：

自古以来，中药在疾病预防、症状缓解和健康改善等方面发挥了重要作用。然而，复杂的成分和尚未明确的机制阻碍了中药的广泛推广和应用。越来越多的研究表明，和人体健康息息相关的肠道微生态与中药的疗效有关，因此从肠道微生态的角度去探索中药可能是打开中药奥秘的金钥匙。肠道菌群主要通过以下4个生理途径中发挥作用：参与宿主代谢、调节系统免疫、维持胃肠道稳态以及影响脑功能和宿主行为。本文回顾了中药与慢性肝病、溃疡性结肠炎、肥胖和2型糖尿病等疾病之间的联系，从肠道微生态的角度阐明其潜在的机制。未来，我们需要进一步的研究和更完善的实验设计，以揭示中药与肠道菌群之间相互作用的具体机制，并为中药的创新研究提供新的思路。

关键词： 中药     肠道菌群     脂肪肝     溃疡性结肠炎     肥胖     糖尿病    

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Evidence chain-based causality identification in herb-induced liver injury: exemplification of a well-known liver-restorative herb

null

《医学前沿（英文）》 2015年 第9卷 第4期   页码 457-467 doi: 10.1007/s11684-015-0417-8

摘要：

Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury (DILI) in the United States. However, reliable methods to identify the DILI causality of some herbs, such as Heshouwu (dried root of Polygonum multiflorum), remain lacking. In this study, a total of 12 307 inpatients with liver dysfunction and 147 literature-reported cases of Heshouwu DILI were screened. A general algorithm indicated that only 22.5% (9/40) and 30.6% (45/147) of all hospitalization and literature case reports, respectively, demonstrate the high probability of DILI causality of Heshouwu. By contrast, 95% (19/20) of all cases prospectively investigated by pharmacognosy, phytochemistry, and metabolomic tests exhibited highly probable causality, including a patient who was previously incorrectly attributed and a case that was excluded from Heshouwu causality by pharmacognostic evidence. Toxin (heavy metals, pesticides, and mycotoxins) contamination was also excluded from Heshouwu DILI causality. The objectivity of these screening methods for Heshouwu DILI diagnosis addresses safety concerns regarding stilbene-containing herbal medicines and dietary supplements.

关键词： drug-induced liver injury     pharmacognosy     metabolomics     stilbene     Polygonum multiflorum     Chinese herbal medicine    

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Practice and principle of traditional Chinese medicine for the prevention and treatment of COVID-19

《医学前沿（英文）》 doi: 10.1007/s11684-023-1040-8

摘要： Traditional Chinese medicine (TCM) has played an important role in the prevention and treatment of coronavirus disease 2019 (COVID-19) epidemic in China. The integration of Chinese and Western medicine is an important feature of Chinese COVID-19 prevention and treatment. According to a series of evidence-based studies, TCM can reduce the infection rate of severe acute respiratory syndrome coronavirus 2 in high-risk groups. For patients with mild and moderate forms of COVID-19, TCM can relieve the related signs and symptoms, shorten the period of nucleic-acid negative conversion, and reduce conversion rate to the severe form of the disease. For COVID-19 patients with severe and critical illnesses, TCM can improve inflammatory indicators and blood oxygen saturation, shorten the hospital stay, and reduce the mortality rate. During recovery, TCM can improve patients’ symptoms, promote organ function recovery, boost the quality of patients’ life, and reduce the nucleic-acid repositive conversion rate. A series of mechanism research studies revealed that capability of TCM to treat COVID-19 through antiviral and anti-inflammatory effects, immune regulation, and protection of organ function via a multicomponent, multitarget, and multipathway approach.

关键词： traditional Chinese medicine     COVID-19     SARS-CoV-2     clinical evidence-based study     mechanism     integrated traditional Chinese and Western medicine    

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Practices, challenges, and opportunities: HIV/AIDS treatment with traditional Chinese medicine in China

Jian Wang, Wen Zou

《医学前沿（英文）》 2011年 第5卷 第2期   页码 123-126 doi: 10.1007/s11684-011-0124-z

摘要： Traditional Chinese medicine (TCM) has become widely used in the treatment of acquired immune deficiency syndrome (AIDS) in China in recent years. In this article, we summarize the recent major developments in human immunodeficiency virus/AIDS (HIV/AIDS) treatment with TCM. The use of TCM is associated with preventing or alleviating HIV-related symptoms, reducing treatment side effects, and improving the quality of life. The potential beneficial effects of TCM should be confirmed through extensive and rigorous trials.

关键词： HIV/AIDS     traditional Chinese medicine    

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标题 作者 时间 类型 操作

欧盟监管环境视角下的传统医药全球化

Werner Knoess, Jacqueline Wiesner

期刊论文

中药生物活性成分对糖脂代谢紊乱疾病的治疗作用和机制

张莹, 鞠佳明, 焦磊, 杨宝峰

期刊论文

中草药在水产养殖中的应用研究进展

蒲红宇, 李晓宇, 杜青波, 崔昊, 徐永平

期刊论文

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