Efficacy and Safety of “Three Chinese Patent Medicines and Three TCM Prescriptions” for COVID-19: A Systematic Review and Network Meta-Analysis

Objective. To systematically evaluate the efficacy, safety, and precision of TMTP for COVID-19. Methods. Randomized controlled trials and retrospective studies were searched in 11 electronic databases. This network meta-analysis included trials using TMTP to treat patients with COVID-19. The traditional pairwise meta-analysis was done by using Stata 15, and Bayesian network meta-analysis was done with WinBUGS. Results. 18 trials were included with 2036 participants and 7 drugs. The results showed that LHQW had the most significant effects on improving expectoration, shortness of breath, sore throat, nausea, emesis, inappetence, muscle soreness, and headache, and it could produce the least adverse reactions. XBJ was the best drug for fever, fatigue, and diarrhea, which showed great advantages in lowering WBC levels. XFBD was the most effective drug for cough and chest distress, which had the least exacerbation rate. JHQG was the most effective for rhinobyon and rhinorrhea, while QFPD was the best drug in decreasing CRP levels. Conclusion. This study was the first most large-scale and comprehensive research of TMTP for COVID-19. The results showed that LHQW had good efficacy without obvious adverse reactions. Therefore, we believe that it should be firstly recommended for COVID-19 treatment. In addition, XBJ is recommended for patients with a severe fever, fatigue, and diarrhea, and JHQG is recommended for patients with obvious rhinobyon and rhinorrhea; then, XFBD is recommended for patients with cough and chest tightness as the main manifestation. Our findings will help experts develop new COVID-19 treatment guidelines to better guide clinical medication for protecting the health of COVID-19 patients.

A Network Meta-Analysis of the Clinical Efficacy and Safety of Commonly Used Chinese Patent Medicines in the Auxiliary Treatment of Poststroke Depression

Background. Poststroke depression (PSD) is a serious complication of clinical cerebrovascular disease. Patients not only have depression-related emotional symptoms but also have physical symptoms, such as autonomic dysfunction. At the same time, patients with varying degrees of depression will delay the neurological function of stroke patients. The recovery time of cognitive function and limb function will increase the risk of accidental death and even aggravate the mortality of cerebrovascular disease. Through combining data analysis and related literature, seven types of Chinese patent medicines (CPMs) widely used in the clinical treatment of PSD have been screened out. These herbs exhibit some clinical comparability under the conditions that the syndrome type and dosage form are relatively uniform. Therefore, in this study, the network meta-analysis method was used to evaluate the safety and efficacy of the seven CPMs screened out, and the probability ranking was performed to screen the best clinical auxiliary treatment plan of CPM. Methods. We searched the Chinese databases, including CNKI, WANFANG, and VIP, as well as the English databases, including the Cochrane Library, EMBASE, and PubMed, from inception to May 31, 2020, to identify randomized controlled trials (RCTs) on seven kinds of CPMs that were the subjects of the clinical research. The bias risk and quality of the included studies were analyzed with the Cochrane Handbook (version 5.1), ADDIS, and R software, and the results were compared in a network meta-analysis (NMA). Results. In terms of clinical effectiveness, the seven kinds of CPMs all improved clinical curative effects, with Jieyu Anshen capsule adjuvant treatment having the most significant effect [odds ratio (OR) = 5.00, 95% CI (1.72–9.48)]. Wuling capsule AT can effectively reduce the score index of scale factors for the HAMD score, NIHSS score, and TESS score [mean difference (MD) = −3.95, 95% CI (−4.88–3.00); OR = −3.25, 95% CI (−5.46)–1.05); OR = 0.22, 95% CI (0.05–0.79), resp.]. Conclusion. The mechanisms of seven CPMs in the adjuvant treatment of PSD have advantages. In terms of safety and efficacy, the CPMs had better clinical adjuvant treatment performance. Although this study concluded that the Jieyu Anshen capsule is the preferred drug for clinical treatment, a clear conclusion still needs to be verified in a high-quality randomized controlled study. In clinical practice, accurate selection and application can be carried out according to the specific characteristics of patients.

Market access of Chinese patent medicine products to healthcare security system in China: implications for international integration of traditional medicine into health systems

Background China has introduced a series of polices and practice to manage the market access of Chinese patent medicine (CPM) products into its healthcare security system, which is less analyzed and reported in current literature. Therefore, this paper aimed to investigate the mechanisms managing market access of CPM products into healthcare security system in China, expecting to provide implications for international integration of traditional medicine products into health systems. Method This paper used a documentary analysis approach as a qualitative research method. Data were collected from four sources and analyzed in a thematic way. Results Four mechanisms to manage entry, price adjustment, and exit of innovative brand and generic CPM products are identified, including: (1) price negotiation, mechanism of new entry of innovative brand CPM products into the national reimbursement list; (2) price re-negotiation, mechanism of price adjustment of innovative brand CPM products within the national reimbursement list; (3) mass procurement, mechanism of generic CPM products to healthcare security system; and (4) direct removal, mechanism of removal from the national reimbursement list. Conclusions China has established market access framework of CPM products by focusing on price negotiation for innovative brand CPM products and mass procurement for generic CPM products. Further studies of CPM products based real-world data are needed to provide clinical and pharmacoeconomic evidence to support market access of CPM products into healthcare security systems.

Research on the impact of Chinese local government patent funding on the development of regional patent

This paper aims to study the impact of Chinese patent funding support on the development of regional patent layout.Data samples were selected from Guangxi, Jiangsu and non-pilot provinces, and data samples were selected from the period 2015-2018.This paper discusses the influence relationship by game theory.The conclusion is that the support of patent funding has a positive impact on economically developed areas and a negative impact on economically less developed areas.Other measures are required to eliminate the aforementioned negative effects.

Integration of Proteomics and Metabonomics in Exploring the Protecting Mechanism of Gushukang Capsule in Osteoporosis Rats

Background Gushukang (GSK) capsule is a Chinese patent medicine for the treatment of osteoporosis (OP). It has been widely used in clinics. However, the specific mechanism and target of GSK in the treatment of osteoporosis is not clear, which needs further study. Methods Metabolomics (GC/MS) and proteomics (TMT-LC-MC/MC) together with bioinformatics (KEGG pathway enrichment), correlation analysis (pearson correlation matrix) and joint pathway analysis (Metabo Analyst) were employed to discover the underlying mechanisms of GSK. Results The regulations of differential proteins Cant1, Gstz1, Aldh3b1, Bid and Slc1a3 in the common metabolic pathway of differential proteins and metabolites between GSK/OP and OP/SHAM were corrected in GSK group. The regulations of 12 metabolites (Tyramine、Thymidine、Deoxycytidine、Cytosine、L-Aspartate and so on) were differential in the common enrichment metabolic pathway between GSK /OVX and OVX/SHAM. Differential proteins and metabolites jointly regulate 11 metabolic pathways, such as purine metabolism, pyrimidine metabolism, histidine metabolism, beta-Alanine metabolism and so on. Conclusion GSK may protect bone metabolism in osteoporosis rats by affecting nucleotide metabolism, amino acid metabolism and immune system.