Emerging issues in traditional Chinese medicine

Traditional Chinese medicine (TCM) has many beneficial effects and has been practiced for several thousand years. It is known to treat the cause of a disease rather than to alleviate its symptoms. Based on a belief that TCM is natural, safe, and of lower cost, consumers worldwide are spending more out-of-pocket money on this form of therapy. This increased spending, and reports of adverse reactions, has drawn the attention of many regulatory agencies. Scientists have called for more evidence-based and scientific research on the risks and benefits of TCM. In Canada, the Natural Health Product Regulations came into effect January 2004. TCM herbal product manufacturers will need to provide products of reputable quality to the market. Many will apply modern technology and good science to support their products. The issues facing producers, scientists, and consumers alike are quality control and assessment, standardization of bioactive components, mechanisms of actions, and integration of the evolved modern Chinese medicine into the healthcare system. Solid science, better regulation of the final product, and better education of consumers are necessary to extract the best of TCM to complement existing conventional medicine to deliver the best healthcare.     

现代生物技术在中药发酵中的应用

发酵是中药炮制一个重要的方面,近年来关于运用现代生物技术来发酵中药的研究越来越多。本文阐述了现代中药发酵的意义、区别传统发酵的优势以及现阶段的发展概况。     

Application of proteomics in research on traditional Chinese medicine

Introduction: Traditional Chinese medicine (TCM) is a widely used complementary alternative medicine approach. Although many aspects of its effectiveness have been approved clinically, rigorous scientific techniques are highly required to translate the promises from TCM into powerful modern therapies. In this respect, proteomics is useful because of its ability to unveil the underlying target proteins and/or protein biomarkers.

Areas covered: In this review, we summarize the recent interplay between proteomics and research on TCM, ranging from exploration of the medicinal materials to the biological basis of TCM concepts, and from pathological studies to pharmacological investigations. We show that proteomic analyses provide preliminary biological evidence of the promises in TCM, and the integration of proteomics with other omics and bioinformatics offers a comprehensive methodology to address the complications of TCM.

Expert commentary: Currently, only limited information can be obtained regarding TCM issues and thus more work is required to resolve the ambiguity. As such, more collaborations between proteomics and other techniques (other omics, network pharmacology, etc.) are essential for deciphering the underlying biological basis in TCM topics.     

中药天麻的研究现状

天麻是我国传统名贵中草药,近年来的研究表明,天麻对中枢神经系统有镇静止痛作用,能增强心肌收缩力,增加冠脉流量,降低外周血压,抗缺血缺氧,并能增强免疫功能．天麻能提高SOD抗氧化酶的活力,消除氧自由基。天麻无任何毒副作用,可反复给药,是一种药理作用广泛的中药材。     

Practice of traditional Chinese herbal medicine shops in central London

The popularity of traditional Chinese herbal medicine (TCHM) in the UK raises questions about the safety of practice of TCHM retail outlets/shops. This pilot study involving twelve TCHM outlets included interviews with six employees to understand some aspects of TCHM practices in London and to assess the feasibility of undertaking this type of work. Overall, eight shops displayed names of medical uses/conditions at their premises. There were 274 occurrences of 137 different terms for uses/conditions displayed; after classification by British National Formulary 49 chapters, the most frequent therapeutic categories to which displayed uses/conditions belonged were Central Nervous System (n = 53/274; 19.3%), Obstetrics, Gynaecology and Urinary-tract Disorders (14.2%) and Skin (13.5%). Most staff interviewed believed TCHM was more effective for chronic problems, and inappropriate for acute conditions. Interviewees considered TCHM safer than western medicines. Interviewees used several strategies to ensure safe and effective practice of TCHM, e.g. giving medical advice to customers. Adverse effects (AEs) occurring during TCHM treatments were considered part of the normal response (e.g. diarrhoea is “expected” with treatments for “clearing heat”). Staff's actions to reported AEs included asking customers to stop taking medicines and consulting colleagues. There are areas where interviewees described behaviours or expressed opinions suggesting a lack of awareness of current safety issues; communication of information on herbal safety between the UK competent authority for regulating medicines and TCHM shops appears to be inadequate.     

中药药效物质的研究方法

中药药效物质的研究是中药现代化研究的核心,科学阐明中药临床治疗的物质基础,是中药药效学研究的最终目标。现阶段中药药效物质基础研究方法主要有化学分离分析、生物色谱法和虚拟筛选等方法。本文对现有中药药效物质基础的几种研究方法进行了分类,并对其特点进行了介绍。     

Microbiome technology empowers the development of traditional Chinese medicine

Science China Life Sciences -     

Application of proteomics in the mechanistic study of traditional Chinese medicine

Systems biology is considered to be the possible technology that could bring breakthroughs in the study of TCM (traditional Chinese medicine). Proteomics, as one of the major components of systems biology, has been used in the mechanistic study of TCM, providing some interesting results. In the present paper, we review the current application of proteomics in the mechanistic study of TCM. Proteomics technologies and strategies that might be used in the future to improve study of TCM are also discussed.     

Gender differences in traditional Chinese medicine use among adults in Taiwan

Objectives

The increasing use of complementary, alternative medicine (CAM) and traditional Chinese medicine (TCM) has attracted attention. We report on the gender difference in TCM use among the general population in Taiwan in a population-based, cross-sectional study.

Methods

We collected data on socio-demographic factors, lifestyle and health behavior from the 2001 Taiwan National Health Interview Survey. The medical records of interviewees aged 20–69 years were obtained from National Health Insurance claims data with informed consent. The prevalence of TCM use and the average frequency of TCM use were compared between women and men.

Results

Among 14,064 eligible participants, the one-year prevalence of TCM use for women and men was 31.8% and 22.4%, respectively. Compared with men, women had a higher average TCM use frequency (1.55 visits vs. 1.04 visits, p<0.001). This significant difference remained evident after excluding gender-specific diseases (1.43 visits vs. 1.03 visits, p<0.001). The average TCM use frequency was significantly higher in women than in men across all age groups. TCM use correlates differed for women and men. Marital status (odds ratio [OR] = 1.55, 95% confidence interval [CI] = 1.30–1.85), family income and unhealthy lifestyle (OR = 1.50, 95% CI = 1.30–1.74) were factors associated with TCM use in men but not in women.

Conclusions

In Taiwan, women used more TCM services than men and the gender differences in the TCM use profile persisted across age groups.     

Herbogenomics: from traditional Chinese medicine to novel therapeutics

Traditional Chinese medicine (TCM) has a long history of development and application and has demonstrated on evidence basis its efficacy in the treatment of many diseases affecting multiple organ systems. In particular, TCM is effective in the prevention and treatment of chronic diseases and metabolic syndromes. However, the value of TCM has not been fully recognized worldwide due to the lack of definitive information of active ingredients in almost any TCM preparation. Novel functional genomics and proteomics approaches provide alternate perspectives on the mechanism of action of TCM. The target molecules on which TCM either activates or inactivates can be identified by functional genomics and proteomics, thus the affected critical signaling pathway cascades leading to effective recovery of chronic diseases can be studied. Several TCM preparations have been available for the treatment of liver fibrosis and cirrhosis, even advanced liver cirrhosis that has been shown to be irreversible and has no US-FDA approved therapy. In the TCM-treated livers with fibrosis and cirrhosis, some critical molecules that are significantly involved in the recovery can be identified through functional genomics and proteomics studies. These molecules become novel targets for drug discovery and development and candidates for the development of gene therapy. Gene therapy developed based on this strategy for the treatment of advanced liver fibrosis and cirrhosis in animal models has obtained promising results. This process thus establishes a herbogenomics approach to understand mechanisms of action of TCM and to identify effective molecular targets for the discovery and development of novel therapeutics.     

Repellent from traditional Chinese medicine, Periploca sepium Bunge

By using a new bioassay-guided method, 2-hydroxy-4-methoxybenzaldehyde isolated from the root bark of Periploca sepium, a traditional Chinese medicine, showed repellent activity against the olive weevil (Dyscerus perforatus) at 62.5, 125, 250 and 500 microg/disc, respectively. In addition, it also exhibited antinematodal activity against Bursaphelenchus xylophilus at a minimum effective dose of 200 microg/ball. The three related compounds obtained were also evaluated for the above-mentioned bioactivities.     

中药对双歧杆菌生长的影响

选用23种常用中药对双歧杆菌进行了体外生长促进实验,结果发现12．5％的黄芪、芦根、桠葫芦分别对双歧杆菌有明显的促进生长作用。同一中药不同浓度对双歧杆菌的增殖效果存在差异。     

Anti-acetylcholinesterase activities of traditional Chinese medicine for treating Alzheimer's disease

Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive memory loss and cognitive impairment. It is the most common type of dementia in the ageing population due to a severe loss of cholinergic neurons in selected brain area. At present, acetylcholinesterase inhibitors (AChEI) are the first group of drugs approved by the FDA to treat mild to moderate Alzheimer's disease. Most of these drugs such as huperzine and galanthamine are originally isolated from plants. In this study, the AChE inhibitory activities from extracts of Chinese medicinal herbs that have traditionally been prescribed to treat insomnia and brain function disorders were examined in a 96-well plate assay based on Ellman's method. Both ethanol and aqueous extracts of 26 traditional Chinese medicinal herbs were tested. Inhibitory effects were expressed as the percentage of inhibition. For the herbal extracts that were shown to exert a significant inhibition, dose-dependent inhibitory assays were also performed. Ethanol and aqueous extracts of six herbs were found to have high AChE inhibitory activities in a dose-dependent manner. The IC(50) of these herbal extracts on inhibition of AChE are at around 5-85mum/ml. The results of this study indicate that there is a great potential to search for novel usage of these medicinal herbs for the treatment of AD.     

中药蟾酥中蟾蜍甾烯类成分研究

目的:研究中药蟾酥的脂溶性化学成分.方法:采用硅胶柱色谱、制备液相等技术分离纯化单体化合物,并根据理化性质及光谱数据鉴定结构.结果:分离得到8个甾体类化合物,并利用1H-NMR,13C-NMR以及文献比较的方法,分离鉴定了它们分别为:华蟾毒精(cinobufagin,1),脂蟾毒配基(resibufagenin,2),蟾毒灵(bufalin,3),蟾毒它灵(bufotalin,4),南美蟾毒精(marinobufagin,5),华蟾毒它灵(cinobufotalin,6),12β-羟基-蟾毒灵(12β-hydroxyl-bufalin,7),5,7β-二羟基-脂蟾毒配基(5,7β-dihydroxyl-resib-ufagenin,8).结论:其中化合物7-8为属中首次发现.     

Cordyceps sinensis, a fungi used in the Chinese traditional medicine

Cordyceps sinensis (Berk.) Sacc. is an ascomycete fungus known in China since antiquity, which is still being used today. A summary, showing relevant papers about this fungus, regarding habitat, history, marketing, consumption, nomenclature, pharmacological composition, culture and medical use, is presented.     

Magnesium as NMDA receptor blocker in the traditional Chinese medicine Danshen

Aqueous extracts of the traditional Chinese medicine Danshen, the dried roots of Salvia miltiorrhiza Bunge (Labiatae), blocked N-methyl-D-aspartate (NMDA) evoked currents in cerebrocortical neurons in vitro. The block of the NMDA-evoked currents was voltage dependent and showed the negative slope conductance reminiscent of the effect of Mg2+ ions. Atomic absorption spectrophotometry (AAS) revealed that aqueous Danshen extracts contained approximately 9mM magnesium. Fractionation of the extracts by high performance liquid chromatography followed by patch clamp recording and AAS indicated that magnesium ions were present in two distinct fractions. One fraction contained approximately 5 mM magnesium and blocked NMDA-induced currents indicating that it contained mostly free Mg2+ ions, while a second fraction did not possess NMDA antagonist activity despite the presence of approximately 4 mM magnesium suggesting that Mg2+ in this fraction was mostly chelated. Following removal of the free Mg2+ by ion exchange chromatography, the previously observed block of the NMDA-induced currents was abolished. These data demonstrate that Danshen contains both free and chelated Mg2+. Free Mg2+ ions account for the NMDA antagonist activity of Danshen in vitro.     

Chinese traditional medicine and abnormal sex ratio at birth in China

A study of the abnormal sex ratio at birth in China reveals that it is not an entirely new phenomenon that emerged since the 1980s, but is simply more visible at present. Deliberate intervention to determine the sex of children has existed in the past few decades, at least in certain groups. Apart from modern medical methods, traditional Chinese medical practice is shown to be highly accurate in identifying the sex of a fetus. This may lead to sex-selective abortion and an abnormal sex ratio at birth. The possible causes of the abnormal sex ratio at birth include not only the real imbalance due to the disturbance of social factors, but also a spurious one attributable to the undercounting of female births. The real magnitude of the imbalance has been exaggerated by statistical error. The phenomenon is a complicated one reflecting the comprehensive socioeconomic setting. Among these factors, the stage of the fertility transition is one of the most decisive.