Traditional Chinese medicine (TCM) originated in ancient China and has evolved over thousands of years. TCM practitioners use herbal medicines and various. Chinese medicine. S82 Transdermal treatment with Chinese herbal medicine: dir__83_cons/bestthing.info 2. European. a case for the integration of traditional Chinese medicine (TCM) into modern medical practice. .. bestthing.info 8. E.C. Moschik et al., .
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CAM. ―A group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine, as. PDF | On Oct 1, , Kevin V Ergil and others published Chinese herbal medicines. PDF | 30 minutes read | In the year , I took a leap of faith to study Traditional Chinese Medicine (TCM). 'You aren't quitting medicine, are you?' my father.
Figure Funnel plot of improvement in KPS during breast cancer treatment.
Figure Improvement and stabilization of performance status during breast cancer treatment. Figure Funnel plot of improvement and stabilization of performance status during breast cancer treatment.
Pre- and posttreatment KPSs were reported in 6 studies. Figure KPS before breast cancer treatment. Figure KPS after breast cancer treatment.
Figure Natural killer cell level before treatment. Figure Natural killer cell level after breast cancer treatment. A subgroup analysis indicated that TNM stage may have affected the homogeneity. The differences in sample size may have contributed to the heterogeneity of the studies.
QoL Six studies reported on QoL, but we were not able to pool these results because each study used a different scale and data type. The study by Semiglazov et al. The intervention group exhibited improvements in the FACT-G total score and in the physical, emotional, and functional well-being scores, and the placebo group had poorer scores. Four studies that reported significantly improved QoL using combined therapy, as assessed using the Chinese version of the FACT-G, were of mixed quality [ 37 , 42 , 50 , 52 ].
Zhong observed improvements in the physical and emotional subscales and the overall health QoL score with CTC therapy [ 52 ].
Wang reported significant within-group improvements in some subscales in both groups, but there were no details of comparisons between groups [ 43 ].
Other Outcomes One high-quality study evaluated CTC therapy for the prevention of chemotherapy-related cognitive dysfunction and reported no significant difference between the two arms [ 23 ].
Discussion Treatment of breast cancer using CHM has been described in Chinese medical texts for more than 2, years.
This review has several limitations. First, we did not identify studies in languages other than Chinese and English.
Therefore, additional studies should be identified from or conducted in these areas to further investigate the efficacy of CHM. Second, all of the included Chinese studies had relatively small sample sizes, ranging from 40 to participants. None of these studies reported the details of sample size calculation.
Third, the Chinese trials did not clearly report allocation concealment or blinding, and none of the Chinese studies were placebo controlled or double blinded, which could have resulted in bias and an overestimation of CTC efficacy [ 58 ].
Publication bias may also have existed. The asymmetry of the funnel plot may be the result of an insufficient number of trials and significant statistical heterogeneity Figures 5 , 7 , 15 , and There were also different data types and assessment methods for outcomes, which may have resulted in statistical heterogeneity. We also cannot ignore the low quality of the included trials; however, that may not be a sound reason to exclude a systematic review. A systematic review embraces the features of systematization and comprehensiveness, which differentiate it from a normal review.
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In addition, the CHM used differed significantly among trials. Inevitably, the pharmacological actions of these treatments would not be the same. A random effects model was used for pooling because of the clinical heterogeneity.
Because of this limitation, we cannot draw a convincing conclusion. Nevertheless, the problems with the current studies identified in this review are significant, and a great deal of work needs to be done to evaluate the efficacy of CAM using a modern and rigorous methodology. Only 3 studies evaluated the Zheng TCM pattern, which is another key limitation of the included studies [ 37 , 42 , 52 ]. Zheng is usually evaluated through a comprehensive analysis of clinical signs and symptoms. TCM practitioners collect the signs by inspection, auscultation, olfaction, inquiry, pulse, and palpation.
CHM therapy is more efficacious when based on the correct judgment of the Zheng classification according to the Chinese medical system. One clinical study found that the therapeutic effect of CHM for the treatment of irritable bowel syndrome was more sustainable when based on the TCM pattern than on standard treatment [ 60 ].
The key role of Zheng in TCM should not be ignored despite the controversial results reported by other clinical studies, which indicate that the efficacy of Zheng-based treatment is not advantageous over standard treatment [ 61 — 63 ]. Patients are not administered the same CHM for a long period of time in real practice, and the treatments reported in clinical trials did not follow a pattern that is commonly used in actual clinical practice because Zheng is dynamic during the treatment course.
Guidelines for safe practice of Chinese herbal medicine
Currently, the process of Zheng is highly subjective, and a nationwide and objective process is needed to improve its use. Randomized, multicenter trials should be conducted for this purpose. Analyses of Zheng at the molecular level may also enable acceptance of TCM on a scientific basis for the West.
Table 2 lists the herbal medicines that were commonly used for the treatment of breast cancer in the identified studies in this review. The pooled data in this review demonstrated that the adjunctive use of CHM with chemotherapy may improve immediate tumor response and performance status and reduce the occurrence of adverse events associated with chemotherapy.
The evidence is too limited to make any confident conclusions. These results suggest that combined therapy has potential benefits for breast cancer patients. The finding of CHM efficacy as an adjunctive therapy for breast cancer is similar to the findings of other reviews for hepatocellular carcinoma, non-small-cell lung cancer, colorectal cancer, and nasopharyngeal carcinoma [ 58 , 64 — 66 ]. A recent systematic review involving 8 RCTs showed that CHM combined with conventional therapy for breast cancer was efficacious in improving QoL and decreasing hot flashes, but this study did not identify as many clinical trials as it could have [ 67 ].
In addition, the review focused on the effects on QoL and hot flashes but did not evaluate other cancer-related symptoms.
Finally, the reviewers only presented a narrative synthesis without a meta-analysis, which made the conclusion unconvincing. Table 2: Herbal medicines commonly used in the treatment of breast cancer. GRADE should be applied to judge the evidence and make recommendations regarding the application of CHM in the treatment of breast cancer.
The present study suggests that recommendations for CHM combined with chemotherapy could be made for breast cancer, but TCM may be too complex to be immediately adopted by physicians in Western countries.
The most fundamental and often-overlooked challenge is the lack of a 1 : 1 correlation between modern allopathic and Chinese holistic medical approaches [ 68 ]. We cannot make specific recommendations despite the rapid increase in the use of CHM and reported potential benefits because of the complexity of this system and the variable data.
Current evidence on the use of CHM as an adjunctive treatment with chemotherapy for breast cancer remains equivocal. Our findings highlight the poor quality of Chinese studies, and additional well-designed RCTs addressing the role of CHM are warranted.
We believe that researchers should immediately explore a CHM-based cure, and CHM should be applied to routine care as soon as conclusive data are available [ 69 ].
Guidelines for safe practice of Chinese herbal medicine
For researchers devoted to the promotion of TCM or CHM, numerous barriers need to be addressed, including the standardizations of the Zheng classification and herbal agents, appropriate study designs, and the identification of the mechanisms of CHM at the molecular level.
Disclosure The authors were not employed or contracted by the funder. The funder did not play a role in study design, data collection, or analysis.
Competing Interests The authors declare that they have no competing interests. References L. Torre, F. Bray, R. Siegel, J. Ferlay, J.
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Lortet-Tieulent, and A. You, R.
An, K. Two review authors extracted and analysed data from trials which met the inclusion criteria. Main results: We found17 studies involving patients.
The methods of 15 studies were at high risk of bias. In only two studies was the risk of bias low. Trials used "positive drugs", of which the efficacy was not known, as controls.
Different Chinese herbal preparations were tested in nearly all trials. In only one trial was a Chinese herbal preparation tested twice. In seven trials, six herbal preparations were found to be more effective at enhancing recovery than the control preparations. In the other 10 studies, seven herbal preparations were not shown to be significantly different from the control.
One study did not describe the difference between the intervention and control groups. You may also be interested in:.Lortet-Tieulent, and A.
The exclusion of any one study did not influence the estimated treatment effect. Chen et al.
Conclusions: the methodology successfully allowed individualized CHM decoctions to be tested rigorously. Tzeng, S.