Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

Modulatory effects of traditional Chinese medicines on gut microbiota and the microbiota-gut-x axis

The gut microbiota offers numerous benefits to the human body, including the promotion of nutrient absorption, participation in metabolic processes, and enhancement of immune function. Recent studies have introduced the concept of the gut-organ axis, which encompasses interactions such as the gut-brain axis, gut-liver axis, and gut-lung axis. This concept underscores the complex interplay between gut microbiota and various organs and tissues, including the brain, heart, lungs, liver, kidneys, muscles, and bones. Growing evidence indicates that gut microbiota can influence the onset and progression of multi-organ system diseases through their effects on the gut-organ axis. Traditional Chinese medicine has demonstrated significant efficacy in regulating the gastrointestinal system, leveraging its unique advantages. Considerable advancements have been made in understanding the role of gut microbiota and the gut-organ axis within the mechanisms of action of traditional Chinese medicine. This review aims to elucidate the roles of gut microbiota and the gut-organ axis in human health, explore the potential connections between traditional Chinese medicine and gut microbiota, and examine the therapeutic effects of traditional Chinese medicine on the microbiota-gut-organ axis. Furthermore, the review addresses the limitations and challenges present in current research while proposing potential directions for future investigations in this area.

Modulatory Effects of XIAOPI Formula on CXCL1 and Selected Outcomes in Triple-Negative Breast Cancer: A Randomized Controlled Clinical Trial

Background

Triple-negative breast cancer (TNBC) is the most aggressive malignancy. Psychological distress and elevated CXCL1 level have been reported to be closely associated with the poor prognosis and quality of life of patients with TNBC. In preclinical studies using xenograft mouse models, XIAOPI formula, a nationally approved drug prescribed to patients at high risk for breast cancer, inhibited CXCL1 expression and improved survival. Traditional Chinese medicine has unique advantages in improving patients' emotional disorders and quality of life. However, the impact of XIAOPI formula on the serum level of CXCL1, psychological distress, and quality of life among patients with TNBC is currently unknown.

Methods

In this study, we designed a randomized, double-blind, placebo-controlled trial. Patients with TNBC were randomly assigned to receive either the XIAOPI formula or a placebo for three months. The primary outcomes include serum CXCL1 expression, Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Secondary outcomes included the Pittsburgh Sleep Quality Index (PSQI) and the Functional Assessment of Cancer Therapy-Breast (FACT-B).

Results

A total of 60 patients with TNBC were enrolled in the investigation. The results showed that the XIAOPI formula significantly decreased CXCL1 expression compared with the control group. Moreover, in comparison to the placebo, the XIAOPI formula increased FACT-B scores while decreasing SDS, SAS, and PSQI scores.

Conclusion

In patients with TNBC, XIAOPI formula may be effective in reducing CXCL1 levels, enhancing psychological well-being, and quality of life. While our research offers a natural alternative therapy that may enhance the prognosis of TNBC, future validation of its therapeutic effects will require large-scale, long-term clinical trials.

Clinical Registration Number

Registration website: www.chictr.org.cn, Registration date: 2018-1-19, Registration number: ChiCTR1800014535.

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction

Objective

Medical disputes and patient satisfaction are related to inappropriate prescribing practices. We aim to investigate the clinical application of prescription reviews for traditional Chinese medicine (TCM).

Method

TCM prescriptions performed prescription reviews in 372 patients from the year 2019 to 2020 were set as the observation group and those from the year 2017 to 2018 without prescription reviews as the control group (n = 341). According to the Criteria for Assessing Prescription Quality in Chinese Hospitals (CAPQCH) items, “Irrational” and “Rational” TCM prescriptions were determined mainly based on the following category: nonstandard prescriptions, inappropriate prescriptions, and hypernormal prescriptions. The incidence of medical disputes and the degree of patient satisfaction were compared between the two groups.

Result

No difference was found in age and gender between the control group and the observation group. The number of irrational TCM prescriptions from the year 2017 to 2020 was 6, 8, 2, and 3, respectively, with the percentage of 3.725%, 4.480%, 1.201%, and 1.446%. The irrational rate in the observation group (1.344%) was significantly lower than that in the control group (4.106%). Specifically, a higher rate of nonstandard prescriptions was revealed in the control group as compared with the observation group. Moreover, a reduced incidence of medical disputes was revealed in the observation group relative to the control group accompanying with the increased degree of patient satisfaction.

Conclusion

Prescription reviews have high application value in the management of Chinese pharmacies, which can improve the rationality of prescriptions, increase patient satisfaction, and reduce medical disputes.