Systematic reporting recommendations are urged to develop for improving the contents and format of case reports in TCM.

Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study.Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM).Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63–0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64–0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73–0.98; p = 0.030) in the per-protocol population.Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.

Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

Background Critics argue that traditional Chinese medicine should focus on a personalised patient experience, and that standardised practices risk killing the traditional art. The development of clinical practice guidelines (CPGs) for Chinese medicine, which began 30 years ago, has risen remarkably over the years. However, for individual practitioners for whom these guidelines are recommended, the impact of the CPGs on clinical practice and their acceptability remain unknown. The aim of this study was to investigate acceptability of standardisation guidelines in traditional Chinese medicine practitioners in China, and the eff ect of CPGs on clinical practice. Methods We did a cross-sectional questionnaire survey of 4503 Chinese medicine practitioners aged 20-65 years from 28 provinces in mainland China, chosen from a random sample of hospitals in a defi ned geographical area. The surveys were administered between July, 2012, and January, 2013. Self-administered questionnaires were used to collect information about acceptability, application, practice change, and outcomes of implementation of CPGs. Basic classifi cation data on specialties and year of qualifi cation were also collected. The institutional ethics committee approved the study protocol. Written informed consent was obtained from all participants. Findings We obtained data for 4495 practitioners, of whom 4461 had complete responses to all items. 3847 (86%) of 4495 Chinese medicine practitioners reported that they were familiar with CPG recommendations, and overall 2265 (50%) adhered to the guidelines. 48 (33%) of 145 doctors with more than 30 years' experience and 712 (52%) of 1369 doctors with less than 5 years' experience reported that they never used CPGs. Doctors in nine specialties showed a modest degree of homogeneity in how eff ective they regarded Chinese medicine with respect to diagnosis and treatment, and were generally positive (ranging from 29 [73%] of 40 ophthalmology specialists to 255 [97%] of 263 anorectal specialists). Most doctors regarded CPG-recommended therapies as safe (4142 [92%] of 4491), economic (3739 [84%] of 4462), and eff ective (3402 [76%] of 4452). After a comprehensive assessment of CPGs, 2714 (61%) of 4461 practitioners regarded the guidelines as acceptable and 839 (19%) 4461 said they would accept them after revision.

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The COVID-19 pandemic has lasted for more than 16 months, and there have been over 169 million confirmed cases worldwide. Besides, after treatment with Western medicine or undergoing home quarantine, COVID-19 patients are still severely or mildly functionally impaired. Though COVID-19 patients were discharged from the hospital, most of them still exhibit certain clinical symptoms such as fatigue, poor appetite, shortness of breath, and poor sleep. The syndromes, linked with the Chinese Medicine (CM) body constitutions, could be due to pre-COVID-19 infections, suffering from the infection, or a post-infection consequence. CM has been used by humans for thousands of years in Asia, especially in Hong Kong, and it is gaining increasing attention and popularity. This study aimed to evaluate the efficacy of CM on alleviating the clinical symptoms of the discharged COVID-19 Patients. This was a multicenter observational and comparative study. One hundred and fifty participants discharged from Hong Kong hospitals were recruited. The patients received three to six months of treatment using CM and were assessed by questionnaires and lung function tests each month during the treatment period and on the 9th month follow-up visit. In light of this global pandemic, we hope this study will bring new opportunities for CM, and facilitate patient recovery and rehabilitation. We believe that this may be the key to promoting rehabilitation.

Background: Although the WHO Trial Registration Data Set (TRDS) has been published for many years, the quality of clinical trial registrations with traditional Chinese medicine (TCM) is still not satisfactory, especially about the inadequate reporting on TCM interventions. The development of the WHO TRDS for TCM Extension 2020 (WHO TRDS-TCM 2020) aims to address this inadequacy. Methods: A group of clinical experts, methodologists, epidemiologists, and editors has developed this WHO TRDS-TCM 2020 through a comprehensive process, including publication of the literature review, consensus collection of the initial items, three-round of Delphi survey, solicitation of comments, revision, and finalization. Results: The WHO TRDS-TCM 2020 statement extends the latest version (V.1.3.1) of TRDS published in November 2017. The checklist includes 11 extended items (including subitems), namely Source(s) of Monetary or Material Support (Item 4), Scientific Title (Item 10a and 10b), Countries of Recruitment (Item 11), Health Condition(s) or Problem(s) Studied (Item 12), Intervention(s) (Item 13a, 13b and 13c), Key Inclusion and Exclusion Criteria (Item 14), Primary and Key Secondary Outcomes (Item 19 to 20), and Lay Summary (Item B1). For Item 13 (Interventions), three common TCM interventions--i.e., Chinese herbal medicine formulas, acupuncture and moxibustion—are elaborated. Conclusions: The group hopes that the WHO TRDS-TCM 2020 can improve the reporting quality and transparency of TCM trial registrations, assist registries in assessing the registration quality of TCM trials, and help readers understand TCM trial design.

Background: Although the WHO Trial Registration Data Set (TRDS) has been published for many years, the quality of clinical trial registrations with traditional Chinese medicine (TCM) is still not satisfactory, especially about the inadequate reporting on TCM interventions. The development of the WHO TRDS for TCM Extension 2020 (WHO TRDS-TCM 2020) aims to address this inadequacy. Methods: A group of clinical experts, methodologists, epidemiologists, and editors has developed this WHO TRDS-TCM 2020 through a comprehensive process, including publication of the baseline survey, draft of the initial items, three-round of Delphi survey, solicitation of comments, revision, and finalization. Results: The WHO TRDS-TCM 2020 statement extends the latest version (V.1.3.1) of TRDS published in November 2017. The checklist includes 11 extended items (including subitems), namely Source(s) of Monetary or Material Support (Item 4), Scientific Title (Item 10a and 10b), Countries of Recruitment (Item 11), Health Condition(s) or Problem(s) Studied (Item 12), Intervention(s) (Item 13a, 13b and 13c), Key Inclusion and Exclusion Criteria (Item 14), Primary and Key Secondary Outcomes (Item 19 to 20), and Lay Summary (Item B1). For Item 13 (Interventions), three common TCM interventions--i.e., Chinese herbal medicine formulas, acupuncture and moxibustion—are elaborated. Conclusions: The group hopes that the WHO TRDS-TCM 2020 can improve the reporting quality and transparency of TCM trial registrations, assist registries in assessing the registration quality of TCM trials, and help readers understand TCM trial design.