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E-raamat: Evidence-based Clinical Chinese Medicine - Volume 17: Colorectal Cancer

(Rmit Univ, Australia), Editor-in-chief (Guangdong Provincial Hospital Of Chinese Medicine, China), Editor-in-chief (Rmit Univ, Australia), (Guangdong Provincial Hospital Of Chinese Medicine, China)
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This seventeenth volume of the Evidence-based Clinical Chinese Medicine series aims to provide a multi-faceted ""whole evidence"" analysis of the management of Colorectal Cancer in integrative Chinese medicine. Beginning with overviews of how colorectal cancer is conceptualised and managed in both conventional medicine and contemporary Chinese medicine, the authors then provide detailed analyses of how colorectal cancer and related disorders were treated with herbal medicine and acupuncture in past eras. In the subsequent chapters, the authors comprehensively review the current state of the clinical trial evidence for Chinese herbal medicines (Chapter 5), acupuncture (Chapter 7), other Chinese medicine therapies (Chapter 8) and combination Chinese medicine therapies (Chapter 9) in the management of colorectal cancer, as well as analyse and evaluate the results of these studies from an evidence-based medicine perspective. Chapter 6 provides a review and a summary of the experimental evidence for the bioactivity of commonly used Chinese herbs. The outcomes of these analyses are summarised and discussed in Chapter 10 which identifies implications for the clinical practice of Chinese medicine and for future research. This book can inform clinicians and students in the fields of integrative medicine and Chinese medicine regarding contemporary practice and the current evidence-base for a range of Chinese medicine therapies used in the management of colorectal cancer, including herbal formulas and acupuncture treatments, in order to assist clinicians in making evidence-based decisions in patient care. The following features mark the importance of this book in the field: An innovative ""whole evidence"" approach: This book combines multiple types of evidence from multiple sources to provide a unique and comprehensive assessment of the available evidence for Chinese medicine in colorectal cancer. Clinically informative and relevant: This book integrates the results of meta-analyses of clinical trial data with evidence from the classical Chinese medicine literature, and the recommendations in contemporary textbooks and clinical guidelines for the application of Chinese medicine. Developed by a skilled team: The authors are internationally recognised, well-respected leaders in the field of Chinese medicine and evidence-based medicine with strong track records in research with multiple publications in the field of cancer.

Disclaimer v
Foreword vii
Purpose of this Book xi
Authors and Contributors xv
Members of Advisory Committee and Panel xvii
Professor Charlie Changli Xue xix
Professor Chuanjian Lu xxi
Acknowledgements xxiii
List of Figures
xli
List of Tables
xliii
1 Introduction to Colorectal Cancer
1(24)
Definition of Colorectal Cancer
1(1)
Clinical Presentation and Subtypes
2(1)
Epidemiology
2(1)
Burden of Disease
3(1)
Risk Factors
4(1)
Pathological Processes and Histology
5(2)
Diagnosis
7(1)
Staging
8(1)
Management
8(8)
Prevention
9(3)
Management of Adenomas
12(1)
Surgical Resection of Primary Tumours
12(2)
Chemotherapy
14(1)
Radiotherapy and Chemo-radiotherapy
14(1)
Targeted Therapies
15(1)
Hyperthermic Intraperitoneal Chemotherapy
15(1)
Elderly Patients
15(1)
Side-effects of Cancer Therapy
16(1)
Post-therapy Follow-up and Monitoring
17(1)
Palliative Care
17(1)
Prognosis
18(1)
References
19(6)
2 Colorectal Cancer in Chinese Medicine
25(30)
Introduction
25(1)
Aetiology and Pathogenesis
25(1)
Syndrome Differentiation and Treatments
26(1)
Treatment Based on Syndrome Differentiation
27(5)
Additional Sources for Treatment Based on Syndrome Differentiation
32(1)
Manufactured Medicines
32(5)
External Chinese Herbal Medicine Treatment
37(4)
Herbal Enemas
38(1)
Suppositories
39(1)
Sitz Baths
39(1)
Topical Applications
40(1)
Hand and Foot Bath
41(1)
Acupuncture/Moxibustion Therapies
41(5)
Other Chinese Medicine Therapies
46(5)
Qi gong Therapies
46(1)
Tut na Therapy
46(1)
Dietary Therapy
46(5)
Principles for Combining Chinese and Western Medicine for Colorectal Cancer
51(1)
Prevention
52(1)
Nursing and Care of the Patient
52(1)
Lifestyle
52(1)
Psychology
52(1)
Prognosis
53(1)
References
53(2)
3 Classical Chinese Medicine Literature
55(42)
Introduction
55(1)
Search Terms
56(1)
Procedures for Search, Data Coding and Data Analysis
56(3)
Search Results
59(10)
Citations Related to the Definitions of the Main Terms
60(1)
Ji Ju and Related Terms
60(3)
Zheng Jia and Related Terms
63(1)
Zang Du and Related Terms
64(1)
Suo Gang Zhi and Related Terms
65(1)
Summary of the Meanings of the Main Terms
66(1)
Citations Related to Aetiology and Syndromes
66(2)
Summary of Aetiology and Syndromes
68(1)
Chinese Herbal Medicine
69(11)
Frequency of Treatment Citations by Dynasty
70(1)
Treatment with Chinese Herbal Medicine
70(2)
Most Frequent Formulas in Citations for Ji Ju and/or Zheng Jia
72(2)
Most Frequent Herbs in Citations for Ji Ju and/or Zheng Jia
74(1)
Most Frequent Formulas in Citations for Zang Du
74(3)
Most Frequent Herbs in Citations for Zang Du
77(2)
Discussion of Chinese Herbal Medicine for Colorectal Cancer
79(1)
Acupuncture and Related Therapies
80(6)
Frequency of Treatment Citations by Dynasty
81(1)
Treatment with Acupuncture and Related Therapies
82(1)
Acupuncture Points in Citations for Ji Ju and/or Zheng Jia
83(1)
Acupuncture Points in Citations for Zang Du
84(2)
Discussion of Acupuncture for Colorectal Cancer
86(1)
Other Chinese Medicine Therapies
86(3)
Discussion of Other Chinese Medicine Therapies
89(1)
Classical Literature in Perspective
89(3)
References
92(5)
4 Methods for Evaluating Clinical Evidence
97(14)
Introduction
97(1)
Search Strategy
98(7)
Inclusion Criteria
99(1)
Study Type
99(1)
Participants
100(1)
Interventions
100(1)
Comparators in Controlled Trials (RCT, CCT)
101(1)
Settings
101(1)
Outcomes
101(3)
Exclusion Criteria
104(1)
Study Type
104(1)
Participants
104(1)
Interventions
105(1)
Comparators in Controlled Trials
105(1)
Outcomes
105(1)
Risk of Bias
105(2)
Statistical Analyses
107(1)
Assessment using GRADE
108(2)
References
110(1)
5 Clinical Evidence for Chinese Herbal Medicine
111(200)
Introduction
111(1)
Previous Systematic Reviews
112(1)
Identification of Clinical Studies
113(1)
Outline of the Data Analyses
113(2)
Section 1 Chinese Herbal Medicine During Postoperative Recovery
115(13)
Randomised Controlled Trials of Oral Chinese Herbal Medicine for Postoperative Recovery
115(1)
Syndromes
116(1)
Formula and Herb Frequencies
116(1)
Risk of Bias
117(1)
Recovery of Gastrointestinal Function
118(1)
Oral Chinese Herbal Medicine plus Usual Postoperative Care versus Usual Postoperative Care
119(2)
Oral Chinese Herbal Medicine plus Fast Track Programme versus Fast Track Programme
121(2)
Oral Chinese Herbal Medicine plus Postoperative Enteral Nutrition versus Postoperative Enteral Nutrition
123(1)
Postoperative Diarrhoea
124(1)
Postoperative Abdominal Distension
124(1)
Postoperative Nausea and Vomiting
125(1)
Postoperative Intestinal Obstruction
125(1)
Karnofsky Performance Scale
126(1)
Postoperative Immune Function
127(1)
GRADE for Oral Chinese Herbal Medicine for Postoperative Recovery
128(2)
Randomised Controlled Trial Evidence for Individual Oral Formulas for Postoperative Recovery
130(4)
Recovery of Gastrointestinal Function and Levels of Immunoglobulins
131(2)
Postoperative Diarrhoea
133(1)
GRADE for Individual Oral Chinese Herbal Medicine Formulas
134(1)
Randomised Controlled Trials of Topical Chinese Herbal Medicine for Postoperative Recovery
135(2)
Risk of Bias for Topical Chinese Herbal Medicine for Postoperative Recovery
137(1)
Recovery of Gastrointestinal Function
138(3)
Postoperative Abdominal Distension
141(1)
Randomised Controlled Trial of Chinese Herbal Medicine Inhalation for Postoperative Recovery
141(1)
Controlled Clinical Trials of Chinese Herbal Medicine for Postoperative Recovery
141(1)
Recovery of Gastrointestinal Function
142(1)
Postoperative Nausea and Vomiting
143(1)
Postoperative Immune Function
143(1)
Non-controlled Clinical Studies of Chinese Herbal Medicine for Postoperative Recovery
143(2)
Safety of Chinese Herbal Medicine for Postoperative Care
145(1)
Section 2 Chinese Herbal Medicine in Conjunction with Chemotherapy
146(114)
Randomised Controlled Trials of Oral Chinese Herbal Medicine in Conjunction with Chemotherapy
146(1)
Syndromes
147(1)
Formula and Herb Frequencies
148(1)
Risk of Bias
148(4)
Oral Chinese Herbal Medicine Versus Chemotherapy
152(2)
Oral Chinese Herbal Medicine for Post-chemotherapy Adverse Reactions
154(1)
Post-chemotherapy Diarrhoea
154(1)
Chemotherapy-induced Peripheral Neurotoxicity
155(1)
Karnofsky Performance Scale
155(1)
Oral Chinese Herbal Medicine plus Chemotherapy versus Chemotherapy
156(1)
Objective Response Rate
156(3)
Survival Rate
159(1)
Overall Survival and Median Survival Time
160(2)
Median Progression-free Survival
162(1)
Time to Progression
163(1)
Recurrence and Metastasis Rates
164(1)
Quality of Life
165(4)
Karnofsky Performance Status
169(4)
Immune Function
173(1)
CD3+Cells
173(2)
CD4+Cells
175(2)
CD8+Cells
177(1)
Ratio of CD4+/CD8+Cells
177(3)
Natural Killer Cells
180(1)
CD8+CD28+T Cells
181(1)
Immunoglobulins
181(1)
Chemotherapy-related Adverse Events
182(1)
Nausea and/or Vomiting
183(5)
Diarrhoea
188(5)
Constipation
193(1)
Gastrointestinal Reactions
193(2)
Myelosuppression
195(1)
Leukocytes
195(3)
Neutrophils
198(2)
Red Blood Cells
200(1)
Haemoglobin
201(3)
Platelets
204(3)
Myelosuppression (Type not Specified)
207(2)
Chemotherapy-induced Peripheral Neurotoxicity
209(5)
Hand-foot Syndrome
214(2)
Fatigue
216(1)
Hepatotoxicity and/or Nephrotoxicity
217(1)
Hepatotoxicity
217(5)
Nephrotoxicity
222(3)
Hepatotoxicity and Nephrotoxicity
225(1)
Heart Function
225(1)
Oral Mucositis
225(2)
Fever
227(1)
Alopecia
227(1)
Skin Rash
228(1)
GRADE for Oral Chinese Herbal Medicine plus Chemotherapy
228(1)
GRADE for Objective Response Rate
229(1)
GRADE for Chemotherapy-induced Nausea and Vomiting
230(1)
GRADE for Chemotherapy-related Abnormal Haematological Parameters
231(1)
GRADE for Chemotherapy-induced Peripheral Neurotoxicity
231(2)
Randomised Controlled Trial Evidence for Individual Oral Formulas in Conjunction with Chemotherapy
233(1)
Objective Response Rate
234(1)
Karnofsky Performance Scale
234(1)
Frequently Reported Herbs in Meta-analyses of Oral Chinese Herbal Medicine in Conjunction with Chemotherapy Showing Favourable Effect
235(3)
Chinese Herbal Medicine Enema and/or Oral Chinese Herbal Medicine plus Chemotherapy versus Chemotherapy
238(3)
Chinese Herbal Medicine Enema plus Chemotherapy versus Chemotherapy
241(1)
Topical Chinese Herbal Medicine plus Chemotherapy versus Chemotherapy
242(1)
Risk of Bias
242(1)
Chinese Herbal Medicine Hand and Foot Bath plus Chemotherapy versus Chemotherapy
243(1)
Chinese Herbal Medicine Cataplasm plus Chemotherapy versus Chemotherapy
244(2)
Controlled Clinical Trials of Chinese Herbal Medicine in Conjunction with Chemotherapy
246(1)
Syndromes
246(1)
Formula and Herb Frequencies
246(1)
Objective Response Rate
246(1)
Survival Rate
247(1)
Karnofsky Performance Status
248(1)
Quality of Life
249(1)
Chemotherapy-related Adverse Events
250(1)
Gastrointestinal Reactions
251(2)
Myelosuppression
253(1)
Leukocytes
254(1)
Red Blood Cells
254(1)
Platelets
255(1)
Chemotherapy-induced Peripheral Neurotoxicity
256(1)
Hepatotoxicity
257(1)
Nephrotoxicity and Heart Function
258(1)
Oral Mucositis
258(1)
Non-controlled Clinical Trials of Chinese Herbal Medicine in Conjunction with Chemotherapy
258(1)
Safety of Chinese Herbal Medicines in Conjunction with Chemotherapy
259(1)
Section 3: Radiotherapy and Chemo-radiotherapy Combined with Chinese Herbal Medicine
260(5)
Risk of Bias
261(1)
Oral Chinese Herbal Medicine plus Radiotherapy versus Radiotherapy
262(1)
Post-radiotherapy Immune Function
262(1)
Chinese Herbal Medicine Enema plus Radiotherapy versus Radiotherapy
263(1)
Oral Chinese Herbal Medicine plus Chemo-radiotherapy versus Chemo-radiotherapy
264(1)
Safety of Chinese Herbal Medicines in Conjunction with Radiotherapy or Chemo-radiotherapy
265(1)
Section 4 Supportive and/or Palliative Care Incorporating Chinese Herbal Medicine
265(9)
Randomised Controlled Trials of Oral Chinese Herbal Medicine
265(1)
Syndromes
266(1)
Formula and Herb Frequencies
266(1)
Risk of Bias
266(1)
Oral Chinese Herbal Medicine versus Best Supportive Care
267(1)
Oral Chinese Herbal Medicine versus Thymosin α1 for Injection
268(1)
Non-controlled Studies of Chinese Herbal Medicine in Conjunction with Supportive Care
269(1)
Case-series Studies
269(1)
Survival Rate
269(2)
Immune Function
271(1)
Tumour Response and KPS
272(1)
Case Reports
272(1)
Safety of Chinese Herbal Medicine in Supportive and/or Palliative Care
273(1)
Evidence for Chinese Herbal Medicine Treatments Commonly Used in Clinical Practice
274(13)
Formulas Based on Syndrome Differentiation
274(1)
Liu jun zi tang
275(3)
Si jun zi tang
278(2)
Bu zhong yi qi tang/wan
280(1)
Shen ling bai zhu san
281(1)
Bai tou weng tang
281(1)
Ba zhen tang
282(2)
Fu fang ban mao jiao nang
284(2)
Hua chan su pian/jiao nang
286(1)
Safety of Chinese Herbal Medicines
287(1)
Summary of the Clinical Evidence for Chinese Herbal Medicine
287(1)
Summary of Results of Randomised Controlled Trials for Main Clinical Outcomes
288(9)
Section 1 Chinese Herbal Medicine Used during Postoperative Recovery
289(1)
Oral Chinese Herbal Medicine
289(3)
Topical Chinese Herbal Medicine
292(1)
Section 2 Chinese Herbal Medicine Used in Association with Chemotherapies
293(1)
Oral Chinese Herbal Medicine
293(2)
Topical Chinese Herbal Medicine
295(1)
Section 3 Chinese Herbal Medicine Used in Association with Radiotherapy or Chemo-radiotherapy
296(1)
Section 4 Chinese Herbal Medicine Used for Supportive and/or Palliative Care
296(1)
References
297(14)
6 Pharmacological Actions of the Common Herbs
311(58)
Introduction
311(1)
Experimental Studies on Bai Zhu
312(5)
Effects in Cancer
313(1)
Atractylenolide I and II
313(1)
Codonolactone
314(1)
Atractylochromene
315(1)
Polysaccharides
315(1)
Anti-inflammatory Effects
315(1)
Immunoregulatory Effects
316(1)
Antioxidant Effects
316(1)
Experimental Studies on Yi Yi Ren
317(3)
Effects in Cancer
317(1)
Anti-inflammatory Effects
318(1)
Antioxidant Effects
319(1)
Experimental Studies on Huang Qi
320(4)
Effects in Cancer
320(1)
Formononetin
321(1)
Astragaloside IV
322(1)
Anti-inflammatory Effects
323(1)
Immunoregulatory Effects
323(1)
Experimental Studies on Fu Ling
324(2)
Effects in Cancer
324(1)
Anti-inflammatory Effects
325(1)
Immunoregulatory Effects
325(1)
Antioxidant Effects
326(1)
Experimental Studies on She She Cao
326(4)
Effects in Cancer
327(2)
Anti-inflammatory Effects
329(1)
Immunoregulatory Effects
329(1)
Experimental Studies on Can Cao
330(2)
Effects in Cancer
330(1)
Glycyrrhizic acid
330(1)
Isoliquiritigenin and liquiritigenin
330(1)
Other compounds
331(1)
Anti-inflammatory and Antioxidant Effects
332(1)
Experimental Studies on Ban Zhi Lian
332(5)
Effects in Cancers
333(3)
Anti-inflammatory Effects
336(1)
Antioxidant Effects
337(1)
Experimental Studies on Dang Shen
337(2)
Effects in Cancer
338(1)
Immunoregulatory Effects
338(1)
Experimental Studies on Ban Xia
339(2)
Effects in Cancers
340(1)
Experimental Studies on E Zhu
341(4)
Effects on Tumours
342(1)
Beta-elemene and delta-elemene
342(1)
Curcumol and isocurcumenol
343(1)
Other compounds
344(1)
Anti-inflammatory Effects
344(1)
Immunoregulatory Effects
345(1)
Antioxidant Effects
345(1)
Summary of Evidence from In Vivo and In Vitro Studies
345(3)
List of Abbreviations
348(1)
References
349(20)
7 Clinical Evidence for Acupuncture and Related Therapies
369(36)
Introduction
369(1)
Previous Systematic Reviews
370(1)
Identification of Clinical Studies
370(2)
Outline of the Data Analyses
372(1)
Studies of Acupuncture and Electroacupuncture
373(17)
Randomised Controlled Trials of Acupuncture and Electroacupuncture
373(1)
Syndromes
374(1)
Frequently Used Points in Randomised Controlled Trials of Acupuncture and Electroacupuncture
374(1)
Risk of Bias for Acupuncture and Electroacupuncture
374(2)
Electroacupuncture versus Sham Electroacupuncture
376(1)
Recovery of Gastrointestinal Function
376(2)
Acupuncture and/or Electroacupuncture versus Postoperative Care
378(1)
Manual Acupuncture for Recovery of Gastrointestinal Function
378(2)
Electroacupuncture for Recovery of Gastrointestinal Function
380(1)
Postoperative Adverse Reactions
381(1)
Quality of Life
382(1)
Warm Needling versus Postoperative Care
382(1)
Recovery of Gastrointestinal Function
383(1)
Immune Function
383(1)
Frequently Reported Acupuncture Points in Meta-analyses
384(1)
GRADE for Acupuncture for Recovery of Gastrointestinal Function
385(4)
Clinical Evidence from Non-randomised Controlled Trials of Acupuncture
389(1)
Clinical Evidence from Non-controlled Studies of Acupuncture
389(1)
Safety of Acupuncture and Electroacupuncture
389(1)
Studies of Acupressure
390(6)
Studies of Ear Acupuncture or Ear Acupressure
391(1)
Risk of Bias for Studies of Ear Acupressure and Ear Acupuncture
392(1)
Ear Acupressure versus Postoperative Care
392(1)
Recovery of Gastrointestinal Function
393(1)
Ear Acupuncture plus Acupuncture and Electroacupuncture versus Sham Interventions
394(1)
GRADE for Ear Acupressure for Recovery of Gastrointestinal Function
395(1)
Safety of Ear Acupuncture and Ear Acupressure
396(1)
Studies of Moxibustion
396(2)
Clinical Evidence for Commonly Used Acupuncture Interventions
398(1)
Summary of Clinical Evidence for Acupuncture and Related Therapies
399(3)
References
402(3)
8 Clinical Evidence for Other Chinese Medicine Therapies
405(8)
Introduction
405(1)
Previous Systematic Reviews
406(1)
Identification of Clinical Studies
406(1)
An mo Remedial Massage
406(5)
Randomised Controlled Trials
406(2)
Risk of Bias
408(1)
Results
409(1)
Time to First Bowel Sounds
409(1)
Time to First Passage of Flatus
409(1)
Time to First Defaecation
410(1)
Postoperative Abdominal Distention
410(1)
Safety of An Mo Remedial Massage
410(1)
Summary of Clinical Evidence for Other Chinese Medicine Therapies
411(1)
References
412(1)
9 Clinical Evidence for Combination Therapies
413(20)
Introduction
413(1)
Identification of Clinical Studies
413(2)
Outline of the Data Analyses
415(1)
Randomised Controlled Trials of Combination Therapies
416(11)
Syndromes
416(1)
Formula, Herb and Acupuncture Point Frequencies
417(1)
Risk of Bias
418(1)
Clinical Evidence for Oral Chinese Herbal Medicine plus Acupuncture/Moxibustion with or without Chinese Herbal Medicine Fomentation Therapy
419(1)
Recovery of Gastrointestinal Function
420(1)
Postoperative Complications
420(1)
Postoperative Immune Function
421(1)
Postoperative Diarrhoea
421(1)
Karnofsky Performance Status
422(1)
Chinese Herbal Medicine Enema plus Acupuncture
422(1)
Recovery of Gastrointestinal Function
423(1)
Topical Chinese Herbal Medicine plus Moxibustion, with or without An Mo
424(1)
Recovery of Gastrointestinal Function
424(2)
Karnofsky Performance Status and Quality of Life
426(1)
Topical Chinese Herbal Medicine plus Electroacupuncture
427(1)
Clinical Evidence from Non-controlled Studies of Combination Therapy
427(2)
Safety of Combination Therapies
429(1)
Summary of Clinical Evidence for Combination Therapies
429(2)
Comparison with Other
Chapters
430(1)
Reference
431(2)
10 Summary and Conclusions
433(26)
Introduction
433(1)
Chinese Medicine Syndrome Differentiation
434(2)
Chinese Herbal Medicine
436(7)
Chinese Herbal Medicine Formulas in Key Clinical Guidelines and Textbooks, Classical Literature and Clinical Studies
439(4)
Acupuncture and Related Therapies
443(5)
Acupuncture Points Used in Key Clinical Guidelines and Textbooks, Classical Literature and Clinical Studies
445(3)
Other Chinese Medicine Therapies
448(2)
Limitations of the Evidence
450(6)
Implications for Practice
453(1)
Implications for Research
454(2)
References
456(3)
Glossary 459(10)
Index 469