Ginger may be a potential remedy for nausea and vomiting. This review aimed to assess the reporting and methodological quality, and integrate the evidence in this field. A total of fifteen meta-analyses were analysed and met the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines, providing a relatively complete statement. However, methodological quality, assessed using the Assessment of Multiple Systematic Reviews-2 checklist, was deemed critically low to low. Our review's findings support ginger's effectiveness in managing chemotherapy-induced nausea and vomiting in cancer patients. It also reduces postoperative nausea and vomiting severity, decreasing the need for rescue antiemetics. Furthermore, ginger shows promise in alleviating pregnancy-related nausea and vomiting symptoms. The pooled evidence suggests ginger as a safe botanical option for managing nausea and vomiting, but it is important to improve the scientific quality of published meta-analyses in the future.

BackgroundThe association between natural products and dietary interventions on liver enzymes is unclear; therefore, this study aimed to examine their effects on liver enzymes in adults.MethodsPubMed, Embase, and Cochrane Library of Systematic Reviews databases were searched from inception until March 2023. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) systems were used to assess the methodological and evidence quality, and the therapeutic effects were summarized in a narrative form.ResultsA total of 40 meta-analyses on natural products (n = 25), dietary supplements (n = 10), and dietary patterns (n = 5) were evaluated, and results were presented in a narrative form. The overall methodological quality of the included studies was relatively poor. The results indicated that positive effects were observed for nigella sativa, garlic, artichoke, curcumin, silymarin, vitamin E, vitamin D, L-carnitine, propolis, and polyunsaturated fatty acids on certain liver enzymes. The dietary patterns, including high-protein, Mediterranean, and calorie-restriction diets and evening snacks, may reduce liver enzymes; however, other supplements and herbs did not reduce liver enzyme levels or have minimal effects. The evidence quality was generally weak given the risk of bias, heterogeneity, and imprecision.ConclusionThis umbrella review suggests that natural products and dietary interventions have beneficial therapeutic effects on liver enzymes levels. Further clinical trials are necessary to establish the effectiveness of supplements that reduce liver enzymes.

基于“心胃相关”理论，认为脾胃失和、心神失调是慢性萎缩性胃炎（CAG）伴焦虑抑郁发生的重要基础，CAG发展过程还受痰瘀等病理因素的影响。临床治疗以健脾护膜、养心安神为本，并通过化湿消滞，通脉和胃祛邪，可取得满意效果。

慢性萎缩性胃炎(chronic atrophic gastritis,CAG)是临床常见的消化系统疾病,与胃癌的发生关系密切.该病病程较长,初期往往并无特殊不适.随着病情进展,多表现为上腹痛、腹胀、早饱、嗳气等消化不良症状.CAG作为胃癌前疾病的一种,若不予以重视和及时治疗,发展为胃癌的可能性较大.研究发现,高浓度胆汁酸患者的胃癌发病率明显高于其他患者.肠道菌群作为人体肠道内的正常微生物,被发现在胆汁酸的合成代谢过程中发挥重要作用.与胆汁酸代谢形成密切相关的胆汁酸-菌群轴或与CAG的发生及进展有关,甚至可导致胃癌.中医认为,脾虚血瘀是CAG的核心病机,胆汁酸-菌群轴与CAG的相关性有重要研究价值.本文以"胆汁酸-菌群轴"为切入点,探讨CAG脾虚血瘀证的病机内涵,以期进一步认识CAG的发病机制.

Background: Ginseng consumption has been associated with various health outcomes. However, there are no review articles summarizing these reports. Methods: PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI and Wanfang databases were searched from inception to 31 July 2022. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence in each meta-analysis, and the results were summarized in a narrative form. Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was relatively poor, with only five studies being low-quality, and 14 critically low-quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported. Conclusion: This umbrella review suggests that ginseng intake has beneficial therapeutic effects for diverse diseases. However, the methodological quality of studies needs to be improved considerably. In addition, it is imperative to establish the clinical efficacy of ginseng through high-quality randomized controlled trials.

Objective:The mechanism of Indigo Naturalis in the treatment of ulcerative colitis (UC) was predicted by GEO chip combined with network pharmacology, and preliminarily verified by molecular docking. Methods:The main active components and targets of Indigo Naturalis were obtained by searching TCMSP, SymMap database, SwissTargetPrediction and Pharmmapper. The UC disease targets were obtained from DrugBank database, OMIM database, TTD database, Disgenet database and GEO gene chips. Venn diagram was used to show drug-disease common targets. The protein-protein interaction (PPI) network of intersection targets was analyzed by String platform, and Cytoscape 3.8.2 software was used to construct the PPI network of components and disease targets. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed on the core targets. AutoDock Vina 1.2.1 was used for molecular docking, and the results were visualized by Discovery studio Visualizer. Results:A total of 10 active components and 184 compound targets of IN-UC, of which 42 were core targets, were enriched and analyzed by GO and KEGG. The therapeutic effect of Indigo Naturalis on UC may involve activation of various process, such as reactive oxygen species metabolism, heme binding, protein phosphatase binding, secretory granule exocytosis, cytoplasmic vesicles, cell focal adhesion and cell substrate connection, and regulates PI3K/Akt signal pathway, human cytomegalovirus infection signal pathway, EB virus infection signal pathway HF1 signaling pathway and insulin resistance signaling pathway to treat UC. Conlusion:Indigo Naturalis has the characteristics of multi-component, multi target and multi pathway in the treatment of ulcerative colitis. Through PTGS2, CAT and other core targets, it can regulate PI3K/Akt signal pathway, human giant cell signal pathway, HIF-1 signal pathway to play a therapeutic role.

Background:Nigella sativa (N. sativa) consumption has been associated with various health outcomes; however, the results are not completely consistent.Objectives:This overview of systematic reviews and meta-analyses aimed to evaluate the reporting and methodological quality, and to grade the available evidence of associations between N. sativa and health outcomes.Methods:PubMed, Cochrane Library, Embase, and Scopus databases were searched from their inception to September 30, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 statement, Assessment of Multiple Systematic Reviews (AMSTAR) 2 checklist, and Grades of Recommendations, Assessment, Development and Evaluations (GRADE) systems were used to assess the reporting, methodological, and evidence quality for each meta-analysis, respectively. The results were synthesized in a narrative form.Results:This overview included 20 eligible meta-analyses published in peer-reviewed journals between 2013 and 2021. The overall methodological quality was relatively poor, with only one moderate quality, four low quality, and 15 critically low quality studies. For reporting quality, items two, five, eight, nine, 15, and 24 need to improve. Among the 110 outcome indicators of the quality of evidence, five were graded as moderate, 17 as low, and 88 as very low. Risk of bias, inconsistency, and imprecision were the main downgrading factors.Conclusion:This overview suggests that N. sativa is beneficial for various clinical outcomes. However, there are certain limitations to reporting and methodological quality. The clinical efficacy of N. sativa requires confirmation in high-quality, large-sample, randomized controlled trials.

Objective: To study the distribution of TCM syndromes of gastric mucosal dysplasia and its correlation with pathological changes. Methods: Using a cross-sectional research method and using unified diagnostic criteria, the pathological diagnosis of 480 patients with low-grade/uncertain dysplasia of gastric mucosal was collected, and the four diagnosis information of Traditional Chinese Medicine, such as primary and secondary symptoms, tongue and pulse, were collected to clarify their TCM syndrome types and pathological tissue classification. The database was established, and the data analysis was carried out by using IBM-SPSS 26.0 software. Results: A total of 480 cases were included in this study, there were 261 patients with low grade dysplasia and 219 patients with uncertain dysplasia. The total frequency of single syndrome and complex syndrome in all patients was 706 times, there were 276 patients with single syndrome, 182 patients with two syndromes and 22 patients with three syndromes. The frequency of syndromes was: liver-stomach stagnation-heat syndrome＞spleen and stomach qi deficiency＞blood stasis of stomach collaterals＞damp-heat in spleen-stomach＞spleen and stomach deficiency and cold＞stagnation of qi in liver-stomach＞deficiency of yin in stomach. The age of spleen and stomach qi deficiency syndrome is higher than that of non spleen and stomach qi deficiency syndrome（P＜0.05）. There is a negative correlation between spleen and stomach deficiency and cold syndrome and atrophy range and atrophy degree（P＜0.05）. There was a positive correlation between spleen and stomach qi deficiency and the extent of dysplasia, atrophy, and intestinal chemosis lesions（P＜0.05）. Conclusion: Liver-stomach stagnation-heat syndrome, spleen and stomach qi deficiency, blood stasis of stomach collaterals are common syndromes of dysplasia; spleen and stomach deficiency and cold syndrome is mostly distributed in the early stage of the disease with less atrophy degree and smaller atrophy range; the spleen and stomach qi deficiency is an important link in the pathogenesis of dysplasia, and it is also a key syndrome in the development of lesions and even canceration. It is often accompanied by qi stagnation, blood stasis, stagnant heat, damp heat, etc.

Berberine is a plant extract widely used in clinical practice. This review aimed to summarize and to grade the available evidence on the association between berberine consumption and health-related outcomes. The PubMed, Cochrane Library, and Embase databases were searched for meta-analyses of randomized controlled trials (RCTs) assessing the efficacy and safety of berberine from inception to June 30, 2022. The AMSTAR-2 and GRADE system were used to assess the methodological quality and evidence level of the included meta-analyses. A total of 11 eligible meta-analyses were identified from 235 publications, which were published in peer-reviewed journals between 2013 and 2022. The results revealed that berberine significantly affects blood glucose levels, insulin resistance, blood lipids, body parameters and composition, inflammatory markers, colorectal adenomas, and Helicobacter pylori infections as compared to controls. Common side effects of berberine consumption include gastrointestinal symptoms, such as constipation and diarrhea. Berberine is a safe medicinal plant ingredient that improves various clinical outcomes; however, there is a need for improvement of methodological quality in published meta-analyses. Additionally, the clinical effects of berberine need to be confirmed in high-quality RCTs.

Chronic gastritis(CG)is a chronic inflammation or atrophic lesion of gastric mucosa caused by various reasons.It is mostly due to the repeated invasion of gastric mucosal epithelium by various pathogenic factors,and the reconstruction of the mucosa due to its specific regeneration function,which eventually leads to the irreversible atrophy or even disappearance of the intrinsic glands of the stomach.Modern research shows that chronic inflammation of gastric mucosa can cause malignant changes in cells and eventually lead to the occurrence of gastric cancer,but its mechanism is still unclear.It is currently believed that effective interven-tion of precancerous lesions such as intestinal metaplasia and dysplasia in the background of gastric mucosal atrophy is the key link in secondary prevention of gastric cancer in CG"inflammation-cancer transformation".In traditional Chinese medicine,spleen defi-ciency is an important pathogenesis of CG"inflammation-cancer transformation",and on this basis,factors such as phlegm damp-ness and blood stasis can accelerate its malignant transformation process.This process is highly consistent with mitochondrial energy metabolism in terms of microscopic performance and occurrence.

Background: The consumption of ginseng has been linked to different health outcomes. Nevertheless, there are no review articles summarizing these reports.Methods: The PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI, and Wanfang were searched from inception until July 31, 2022. The methodological quality and quality of evidence in each meta-analysis were evaluated utilizing the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) systems. The findings were subsequently presented in a narrative format.Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was suboptimal, with only five studies being low quality and 14 critically low quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina, and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported.Conclusions: This umbrella review suggests that ginseng can improve a wide range of clinical outcomes. Furthermore, it is imperative to establish the clinical efficacy of ginseng through randomized controlled trials of superior quality.

China has a high incidence of gastric cancer. Secondary prevention of gastric cancer is a major public health problem that must be solved urgently. Modern medicine focuses on the pathogenesis of precancerous lesions of gastric cancer (PLGC), and it has been found that there are a variety of abnormal gene expression patterns in PLGC. This study summarizes recent advances in our understanding of the therapeutic mechanisms of PLGC from various clinical studies; this will provide a reference for studying the therapeutic mechanisms of Traditional Chinese Medicine in the treatment of PLGC from the combined points of view of Traditional Chinese and Conventional medicine.

补中益气汤是中医学经典名方之一,是著名医家李东垣治疗脾胃病思想的集中体现.温艳东教授从事消化系统疾病的医疗、科研、教学工作近30年,十分擅长运用中西医结合方法诊治消化内科常见病、疑难病.温艳东教授临床应用补中益气汤强调辨病辨证相结合,组方用药灵活,经验丰富,效如桴鼓.本文将通过重温补中益气汤的理论渊源,详细介绍温教授应用补中益气汤治疗脾胃病的学术思想和特色经验,系统阐述温艳东教授临证思路和诊病特点,并佐以温艳东教授临床应用补中益气汤治疗脾胃病之验案,以飧同道.

慢性萎缩性胃炎是常见的消化系统疾病,伴有异型增生的组织病理学改变时,称为胃癌前病变.癌前病变是慢性萎缩性胃炎演变成胃癌的关键环节,具有一定的可逆性.本文基于"脾虚邪滞"阐述慢性萎缩性胃炎癌前病变机理,探讨健脾培元、通滞祛邪在其治疗中的应用,为相关防治提供新思路.

Background:Chronic atrophic gastritis (CAG) is an important stage of precancerous lesions of gastric cancer, and also a key period of drug intervention. However, there is still a lack of drugs to maintain the treatment of CAG until the advent of moluodan. Objective:This study was conducted to assess the clinical efficacy of moluodan in the treatment of CAG by meta-analysis and trial sequential analysis. Methods:China National Knowledge Infrastructure, China Biology Medicine, VIP, Wanfang, Embase, PubMed, the Cochrane Library, and Web of Science databases were searched, all with the time limit from database establishment to July 2022. The published randomized controlled trials of moluodan for CAG were conducted for meta-analysis and trial sequential analysis. Results:7 studies with a total sample size of 1143 cases were included. Compared to folic acid/vitamins, moluodan alone significantly increased the effective rate of pathological detection (relative risk [RR] = 1.73, 95% confidence interval [95%CI] = [1.48,2.02], P < .00001), and moluodan in combination with folic acid/vitamins significantly increased the effective rates of pathological detection (RR = 1.37, 95%CI = [1.23,1.52], P < .00001), gastroscopy (RR = 1.37, 95%CI = [1.18,1.60], P < .0001) and symptoms (RR = 1.25, 95%CI = [1.13,1.38], P < .0001). Harbord regression showed no publication bias (P = .22). Quality of evidence evaluation demonstrated moderate quality of evidence for all indicators. Conclusions:Moluodan can improve the effective rates of pathological examination, gastroscopy and symptoms in patients with CAG, and play a role in slowing down the disease progression and reducing clinical symptoms. It may be a potential drug for the treatment of CAG and has the value of further exploration.

在肠易激综合征(IBS)相关中医药临床研究中,如何通过恰当的临床疗效评价指标对其开展临床疗效评价是目前存在的问题之一.受中华中医药学会脾胃病分会委托,编制的《关于肠易激综合征中医药临床疗效评价指标体系中若干问题的专家共识》分为概述、IBS临床疗效评价指标体系的选择与应用、IBS临床疗效评价指标的分析与处理、结果解释4个部分内容,对IBS临床疗效评价指标体系的相关问题进行说明,为相关人员提供参考.