Application of Traditional Chinese Medicine in medical practice: a survey of community residents in Beijing, China

Practices, Knowledge, and Attitudes of Chinese University Students Toward Traditional Chinese Herbal Medicine for the Control of COVID-19

BACKGROUND

The application of traditional Chinese herbal medicine has been officially recommended and strongly promoted in China as an important complement to conventional prevention and treatment for COVID-19. Capturing the practices, knowledge and attitudes of young adult population toward using Chinese herbs for COVID-19 is important for understanding the future of Chinese herbal medicine over the coming decades.

METHODS

This cross-sectional questionnaire-based study was conducted from May to June, 2022, among 313 student volunteers in Wuhan University of Science and Technology, a provincial comprehensive university in China.

RESULTS

Results showed that only 18% of students had used Chinese herbs to prevent COVID-19. The main information sources were social media, the students' family members, relatives, friends, etc. as well as the healthcare professionals. However, most students only sometimes paid close attention to related reports and news articles in social media. Clear pharmacological and toxicological properties of herbs were considered by 43% students as the most important factor to promote their own application of Chinese herbs to fight COVID-19. The mean knowledge score was 1.64 out of 5. Students' overall attitudes toward application of Chinese herbal medicine to fight COVID-19 were very positive.

CONCLUSION

These data suggests most university young adults had a positive attitude but lack of practices and knowledge towards traditional Chinese herbal medicine for COVID-19 control.

A Scoping Review of Cross-Sectional Studies on Traditional Chinese Medicine

Cross-sectional studies on traditional Chinese medicine (TCM-CSs) have become the most published type of TCM observational study; however, the research scope of current TCM-CSs is unknown. A scoping review of the literature was performed. A descriptive approach to summarize the core study characteristics was prepared, along with structured tables and figures to identify salient points of similarities and differences noted across studies. The reporting quality of TCM-CSs was assessed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) cross-sectional checklist. Eight databases (Embase, CENTRAL, MEDLINE, AMED, CBM, CNKI, WanFang, and VIP) were systematically searched for TCM-CSs published up until 20 January 2020. The literature screening and evaluating were independently conducted by two researchers. When there was disagreement, a third-party senior researcher made the judgment. A total of 198 TCM-CSs published between 1997 and 2019 were included, 160 English studies and 38 Chinese studies, respectively. More TCM-CSs were published in each successive year. The journal Evidence-Based Complementary and Alternative Medicine published more TCM-CSs (24) than any other journal. Most TCM-CSs were conducted in mainland China (81, 40.9%), followed by Taiwan, China (44, 22.2%) and HKSAR, China (19, 9.6%). The most commonly used sampling method was purposive sampling (94, 47.5%), following by convenience sampling (60, 30.3%). The research topics can be summarized in four major categories as follows: constitution-related research (11.1%), TCM pattern-related research (18.7%), TCM intervention-related research (55.1%), and others (15.6%). The average sufficient reporting rate of included TCM-CSs according to the STROBE cross-sectional checklist was 45.6%. Papers written in English reported 9 items (items 2, 4, 14a, 16a, 18, 19, 20, 21, and 22) more frequently than papers written in Chinese. The number of TCM-CSs is increasing. Research topics are diverse; however, the reporting quality is unsatisfactory. In particular, TCM-CSs need greater transparency and standardization.

Knowledge of medical professionals, their practices, and their attitudes toward traditional Chinese medicine for the prevention and treatment of coronavirus disease 2019: A survey in Sichuan, China

This study aimed to investigate the knowledge, practices, and attitudes of medical professionals toward Traditional Chinese Medicine (TCM) for the prevention and treatment of coronavirus disease 2019 (COVID-19). All 401 medical professionals were surveyed using an anonymous with an investigator using the Questionnaire star APP. The participants answered 14 questions; of the 401 participants, 55.2% agreed with the statement “TCM can be used for the prevention and treatment of COVID-19,” 40.4% remained neutral, and 4.4% disagreed. Moreover, 75.3% agreed with the statement “There is no specific drug for COVID-19,” 67% agreed with the statement “TCM can develop immunity to COVID-19” and 62.1% agreed with “TCM can alleviate the symptoms of patients with COVID-19.” Meanwhile, 69.1% were aware that TCM has been recommended for COVID-19 by the National Health Commission of the People’s Republic of China. Regarding the selection of sources of knowledge on whether “TCM can be used for the prevention and treatment of COVID-19,” There were 277, 123, 82, 369, and 17 participants selected sources from “Hospital training,” “Academic journals,” “Academic Conferences,” “Social media platforms (such as WeChat)” and “Others,” respectively. Further, 358 participants will take TCM for the prevention of COVID-19. Multiple logistic regression analysis showed that age, major and received TCM treatment within the last five years were independent factors affecting the participants’ attitudes. In the absence of specific drugs for COVID-19, more than half of the participants agreed that TCM could be used for the prevention and treatment of COVID-19 and most participants are willing to take TCM to prevent COVID-19, although unsure about its effectiveness. The main information sources on TCM for the treatment and prevention of COVID-19 were social platforms and hospital training.

Trends and Patterns in Traditional Chinese Medicine Use Among Chinese Population in Late Adulthood: An Eight-Year Repeated Panel Survey

Traditional Chinese medicine (TCM), originated from China, is different from Western medicine in theory and practice. This study aimed to document the longitudinal trends and the patterns by demographical characteristics in the prevalence of TCM among the middle-aged and elderly Chinese population. This study used nationally representative longitudinal survey data from the China Health and Retirement Longitudinal Study (CHARLS), covering approximately 20,000 individuals in each panel survey from 2011 to 2018. The questions regarding medication use in the questionnaire was used to identify the TCM users. The prevalence of using TCM for treating chronic diseases among the patients with chronic diseases stabilized between 2011 and 2018, while the prevalence of TCM use for any purpose among the overall population climbed from 19.03% (95% CI 18.37% to 19.69%) in 2011 to 23.91% (95% CI 23.23% to 24.60%) in 2015. Moreover, the prevalence of TCM use for nonchronic conditions among the overall population increased during the same period as well. The TCM users were more likely to be females and city dwellers. The increasing prevalence of TCM use for any purpose among the overall population reflects the increasing influence and potentials of TCM by year. With the expected rising demand in TCM for the following decades in China, more clinical trials on safety and healthcare policy regarding TCM are merited in the future.

Study on the Anticancer Effect of an Astragaloside- and Chlorogenic Acid-Containing Herbal Medicine (RLT-03) in Breast Cancer

Background

Although surgery, chemotherapy, radiotherapy, and endocrine therapy are widely used in clinical practice for breast cancer treatment, herbal medicines (HMs) are considered as an alternative to palliative treatments because of their coordinated intervention effects and relatively low side effects. Astragaloside (AS) and chlorogenic acid (CGA) are major active ingredients of Radix Astragali and Lonicera japonica, which have shown antitumorigenic properties in certain cancers, but the role of HMs containing both AS and CGA remains unclear in breast cancer. In this study, we explored an AS- and CGA-containing HM (RLT-03) extracted from Radix Astragali, Lonicerae Japonicae Flos, Trichosanthin, and Rhizoma imperatae.

Methods

RLT-03 was extracted using water and n-butanol, and the AS and CGA ingredients in RLT-03 were identified by high-performance liquid chromatography (HPLC) and evaporative light-scattering detector (ELSD). 4T1, EMT6, BT-549, and MDA-MB-231 breast cancer cell lines were used, and an EMT6 xenograft model was established. Cell proliferation, migration, and apoptosis were measured in vitro, and tumor volume and weight were observed in vivo. The expression of VEGF, EGF, IL-10, TGF-β, and CD34 and cell apoptosis in tumors were examined.

Results

RLT-03 inhibited cell viability and induced apoptosis in a dose- and time-dependent manner. In vivo, tumor volume and weight were reduced, and the expression of VEGF, EGF, IL-10, TGF-β, and CD34 was suppressed in the tumor microenvironment, while cell apoptosis was induced.

Conclusion

RLT-03 exhibited therapeutic effects against breast cancer by regulating the expression of ligands of receptor tyrosine kinases (RTKs) and inflammatory factors. Thus, RLT-03 represents a potential supplementary HM that can be used in breast cancer therapy.

Effects of Astragaloside IV on treatment of breast cancer cells execute possibly through regulation of Nrf2 via PI3K/AKT/mTOR signaling pathway

Traditional Chinese medicine (TCM) has from ancient times been applied in China for the treatment of breast cancer with its own unique theoretical system. Sanhuang decoction composed of astragalus membranaceus, prepared rhubarb, and rhizoma curcumae longae has traditionally been used for antioxidant stress, inflammatory reaction, and angiogenesis. However, the role and mechanism of Sanhuang decoction in breast cancer remains unknown. The present study demonstrated the antitumor activity of Sanhuang decoction against breast cancer xenografts in nude mice. Notably, Sanhuang decoction promoted severe necrosis and induced cell death. In addition, Sanhuang decoction obviously regulated the inflammation and oxidative stress. Despite these, Sanhuang decoction could increase the expression of Nrf2. Moreover, si-Nrf2 exhibited the opposite effects compared with the Sanhuang decoction treatment group and reversed the antibreast cancer role of Sanhuang decoction. Further, Sanhuang decoction remarkably suppressed the expression of PI3K/AKT/mTOR signaling pathway. Taken together, Sanhuang decoction was firstly evaluated to possess potent antibreast cancer effect in vivo through regulation of inflammation and oxidative stress accomplished by up-regulation of Nrf2 via PI3K/AKT/mTOR signaling pathway and Sanhuang decoction might be a powerful candidate formula for antibreast cancer.

Utilization of Traditional Chinese Medicine Practitioners in Later Life in Mainland China

Mainland China is one of the world's most rapidly aging countries, and yet there is very limited literature on traditional Chinese medicine (TCM) use in older individuals. This study aimed to determine the national and provincial prevalence of TCM practitioner utilization in later life and associated factors. We used World Health Organization China Study on Global Aging and Adult Health Wave 1 data to determine descriptive statistics of the study population of participants aged 50 years and over. Multivariate logistic regression was conducted controlling for sociodemographic and health factors. A total of 14% of participants utilized a TCM practitioner, and the prevalence of utilization varied significantly by locality. Utilization was more likely in participants living in rural areas [adjusted odds ratio (OR) = 12.96; p < 0.001], Hubei (OR = 7.17; p < 0.001), or Shandong provinces (OR = 4.21; p < 0.001) and being diagnosed with chronic lung disease (OR = 1.97; p = 0.005). Hence, rurality, provincial influence, and chronic lung diseases are significant factors associated with TCM practitioner utilization among older individuals in China. These findings may inform policy for preservation and development of TCM nationally as well as its sustainability in an increasingly aging society.