Abstract
Background:
The purpose of this review was to analyze treatments for hepatolenticular degeneration (HLD) in traditional Chinese medicine (TCM), exploring the potential mechanisms and latest advances, as well as potential future directions.
Methods:
We searched articles from the China National Knowledge Infrastructure, the Wanfang database, the Chinese Medical Journal Database, PubMed, the Cochrane Library, and Embase. We used CiteSpace (version 5.8. R3) and VOSviewer (version 1.6.17) software for visual analysis of bibliometrics.
Results:
We selected a final total of 532 studies for visual analysis. In terms of authors, Yang Wenming was the most prolific author in this field, and there were 5 coauthor teams, namely Yang Renmin’s team, Bao Yuancheng’s team, Yang Wenming’s team, Chen Huaizhen’s team, and Han Hui’s team. The top 5 research topics focused on TCM syndrome (13.45%), clinical efficacy (9.45%), integrative medicine (6.91%), liver fibrosis (6.36%), and cognitive dysfunction (4.18%). The top 5 clusters were “#1 Gandouling tablet,” “#2 Gandou Fumu decoction,” “#4 Gandou decoction,” “#5 Clinical Efficacy,” and “#8 Theoretical research.” Research hotspots changed over the past decades, and current studies looked at damp-heat syndrome, phlegm stasis syndrome, and the efficacy of prescriptions.
Conclusion:
Currently, studies in TCM syndromes are relatively limited, and although the field of TCM in HLD is rapidly developing with established networks of teams and collaborations, large-scale collaboration is still in its infancy. Looking toward the future, despite the deficiencies in this field, it is crucial to further explore the advantages of integrative medicine for treating HLD.
Keywords: bibliometrics, CiteSpace, hepatolenticular degeneration, traditional Chinese medicine, VOSviewer
1. Introduction
Hepatolenticular degeneration (HLD) is an inherited disease of copper metabolism that involves movement disorders. Its characteristic clinical manifestations include gradually progressing neuropsychiatric symptoms, liver and kidney damage, and the presence of the Kayser–Fleischer ring.[1] HLD is a challenging and rare disease globally, with a morbidity of 15 to 30/1,000,000 among different populations, a prevalence rate of about 1/30,000, and approximately 1 out of 90 people may be carriers of the disease gene; in China, Cheng et al[2] estimated the morbidity of HLD to be about 1.96/100,000, with a prevalence rate of about 5.87/1,000,000.
HLD is primarily caused by an ATP7B gene mutation that restricts the activity of copper-transporting P-type ATP7Base (ATP7Base). As a result of this, excessive copper ions (Cu2+) cannot be transported from the liver cells, resulting in an excessive deposition of Cu2+ in the liver, brain, kidney, and other parts of the body. Misdiagnosis is common in HLD as its various clinical manifestations can be confused with other neurological diseases.
HLD has been researched in traditional Chinese medicine (TCM) for over 40 years, and considerable progress has been made during this period in understanding its etiology, pathogenesis, diagnosis, treatment strategies, and evaluation of clinical efficacy. Previous studies showed that TCM is better tolerated by patients, can promote 24-hour urinary copper excretion, and effectively improves neural, liver, and kidney function. Its mechanism of action may be related to reversing the ATP7B gene mutation, antioxidation, inhibiting apoptosis and proliferation, anti-inflammation, and anti-fibrosis. Integrative medicine is considered the optimal treatment strategy for HLD, especially for patients in the early or maintenance stage.[3]
Bibliometrics can enable the identification of hotspots, trends, and frontiers in research. The visual analysis of bibliometrics with the help of CiteSpace and VOSviewer can convert large amounts of research data into visualized scientific landscapes using mathematical and statistical methods, exploring the current status of literature and frontiers in various focus fields from the micro (individual), meso (topical), and macro (global) perspectives.[4] In this study, our aim was to review the efforts to treat HLD in TCM using CiteSpace and VOSviewer software, as well as explore the potential mechanisms and frontiers in its development and provide future research directions.
2. Materials and methods
2.1. Search strategy
We used the terms “hepatolenticular degeneration” and “traditional Chinese medicine” as subject headings and searched literature databases such as the China National Knowledge Infrastructure, the Wanfang database, the Chinese Medical Journal Database, PubMed, the Cochrane Library, and Embase from the year of publication to December 31, 2023. The date of data acquisition was November 2, 2024.
2.2. Data handling
We exported the data retrieved from the above literature databases in NoteExpress format. We excluded repeated articles after checking the duplicates with NoteExpress software (version 3.2.0.7276). We conducted a preliminary screening by reviewing the titles and abstracts, deleting irrelevant articles, conference papers, achievements reports in science and technology, newspapers, webpage news, and newsletters. After cross-checking, we downloaded the full texts of all relevant articles, finalized the set of included studies by reading through the full text, and exported the final data in the Refworks and Refworks-CiteSpace formats.
2.3. Data extraction
We extracted relevant information from the final articles, such as year of publication, journal, title, first author, location, type, funding, keywords, and number of coauthors, and entered these into a specifically designed Microsoft Excel (2019 MSO) spreadsheet. Then, as per Wilson disease,[5] Guidelines for the Clinical Study of Traditional Chinese Medicines (Trial),[6] and List of National Colleges and Universities (As of May 31, 2022),[7] we standardized institutions, keywords, and definitions in TCM. Terms such as “Chinese herbal medicine,” “Integrative medicine,” “Chinese medicine,” etc were unified into “traditional Chinese medicine”; “Wilson disease,” “Wilson's disease,” etc were revised into “hepatolenticular degeneration.”
2.4. Statistical analysis
We developed a visual analysis of bibliometrics using CiteSpace (version 5.8. R3) and VOSviewer (version 1.6.17) software. Time slicing was set from January 1965 to December 2022, and this was divided into 58 time zones (slice length = 1). Visualized scientific landscapes were constructed based on institution, author, and keyword information. Modularity (Q value) and silhouette (S value) were used to assess the effect of clustering. A Q value >0.3 and/or a S value >0.5 indicated a creditable cluster structure, and the closer the value was to 1, the higher the homogeneity of the cluster. In the cluster diagram, node size was used to represent the frequency of terms, the thickness of links indicated link strengths between nodes, the burst time of terms was expressed by a stepwise shift between cool and warm colors, and frontiers and trends were determined by keyword bursts.[8] We used VOSviewer software to visualize the analysis for co-authorship, co-occurrence, and keywords, with the minimum number of occurrences of terms set to 5.
3. Results
3.1. Annual distribution of publications
We included 532 studies in the final visual analysis, consisting of 140 theses and 392 journal articles. There was a slow rate of publication between 1965 and 1995, followed by a slight upward trend that continued from 1996 to 2006. The number of annual publications rapidly increased between 2007 and 2023 with occasional fluctuations, with the highest number of publications reaching 85 in 2023 (Fig. 1).
Figure 1.
Number of TCM publications on HLD from 1965 to 2023. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.2. Research topics
We analyzed descriptive statistics based on the research topics with a frequency of more than 10. The top 5 research topics in the field of TCM on HLD were TCM syndrome (13.45%), clinical efficacy (9.45%), integrative medicine (6.91%), liver fibrosis (6.36%), and cognitive dysfunction (4.18%). Studies based on TCM preparations such as the Gandou decoction, Gandouling tablet, and Gandou Fumu decoction accounted for a significant proportion of the publications. Details are shown in Figure 2.
Figure 2.
Distribution of TCM research topics pertaining to HLD. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.3. Journals
There were 392 studies published in 137 different journals. Journals that published more than 5 studies included the Clinical Journal of Traditional Chinese Medicine, the Journal of Anhui University of Chinese Medicine, the Chinese Journal of Experimental Traditional Medical Formulae, the Chinese Journal of Integrated Traditional and Western Medicine, the Journal of Traditional Chinese Medicine, the China Journal of Traditional Chinese Medicine and Pharmacy, and the Liaoning Journal of Traditional Chinese Medicine. The average (2023) comprehensive impact factor (IF) of the top 10 journals was 2.919, as per evaluation data from China National Knowledge Infrastructure. Details are given in Figure 3.
Figure 3.
Distribution of TCM journals (frequency ≥5) pertaining to HLD. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.4. Authors
3.4.1. Regional distribution of first authors
We analyzed the regional distribution of the first authors in 532 articles. We found that the first authors in studies of HLD in TCM came from 25 different national provinces (autonomous regions, municipalities) in China, with those from Anhui, Shandong, Shanghai, Hubei, and Guangdong publishing more than 5 articles. There were 307 first authors from Anhui alone. Details are given in Figure 4.
Figure 4.
Regional distribution of first authors on HLD in TCM publications. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.4.2. Regional distribution of coauthors
In the CiteSpace software platform, we selected “Author” in node types, the “Top 50%” for the level of most frequently occurring items from each slice in the selection criteria, and retained other settings as default. Our results showed that Yang Wenming from the Anhui University of Chinese Medicine with 88 articles was the most prolific author in this field, followed by Han Hui (44), Yang Renmin (38), Zhang Juan (36), Bao Yuancheng (35), Wang Meixia (35), Han Yongzhu (34), and Wang Han (33).
Network visualization showed 630 nodes, 2345 links, and a density of 0.0194 among them. There were 5 coauthor teams: Yang Renmin’s team, Bao Yuancheng’s team, Yang Wenming’s team, Chen Huaizhen’s team, and Han Hui’s Team. Cai Yongliang had the highest centrality with 0.09, followed by Han Hui, Wang Han, Yang Wenming, and Bao Yuancheng with a centrality score of 0.06, respectively. The collaborative relationship between different authors and teams would be strengthened by combining the results of network, overlay, and density visualization. Details are shown in Figure 5.
Figure 5.
Cluster diagram of coauthors’ relationships in HLD. HLD = hepatolenticular degeneration.
3.5. Institutions
We generated a cluster diagram of institutions by selecting “Co-occurrence,” “Keywords,” and “Full counting” in the “Types of Analysis and Counting Method” section and set the minimum frequency of co-occurrence as 2 in the “Choose Threshold” option in the VOSviewer software platform. The top 5 institutions were the Anhui University of Chinese Medicine, The First Affiliated Hospital of the Anhui University of Chinese Medicine, and The Institute of Neurology of the Anhui University of Chinese Medicine, The First Affiliated Hospital of the University of Science and Technology of China, and the Anhui Medical University. Details are shown in Figure 6.
Figure 6.
Cluster diagram of TCM institutions working on HLD. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.6. Keywords
3.6.1. Frequency
In the CiteSpace software platform, we selected “Keyword” in “Node Types,” “Top 50%” for the level of most frequently occurring items from each slice in the selection criteria and retained other settings as default. We found 69 terms with a frequency of ≥5, with a cumulative frequency of 1039. The top 10 keywords were “traditional Chinese medicine symptoms,” “Gangou decoction,” “Goudouling tablet,” “clinical efficacy,” “integrative medicine,” “liver fibrosis,” “reviews,” “intermingle phlegm and blood stasis syndrome,” “dampness - heat syndrome,” and “animal model.” Details are shown in Figure 7 and Table 1.
Figure 7.
Visualized scientific landscapes of keywords in HLD. HLD = hepatolenticular degeneration.
Table 1.
Keywords analysis in TCM on HLD.
| Frequency | Keyword | Centrality | Frequency | Keyword | Centrality |
|---|---|---|---|---|---|
| 74 | Traditional Chinese medicine symptoms | 0.25 | 22 | Case report | 0.08 |
| 70 | Gandou decoction | 0.24 | 21 | Gandou Fumu decoction | 0.07 |
| 52 | Clinical efficacy | 0.23 | 21 | Etiology and pathogenesis | 0.06 |
| 59 | Gandouling tablets | 0.19 | 20 | Animal model | 0.10 |
| 38 | Integrative medicine | 0.11 | 18 | Liver damage | 0.14 |
| 35 | Liver fibrosis | 0.22 | 17 | Metabolomics | 0.08 |
| 32 | Reviews | 0.06 | 16 | Cirrhosis | 0.05 |
| 26 | Dampness-heat syndrome | 0.06 | 14 | Mental disorder | 0.04 |
| 25 | Intermingled phlegm and blood stasis syndrome | 0.07 | 13 | D-penicillamine | 0.04 |
| 23 | Cognitive dysfunction | 0.12 | 13 | therapeutic principle and method | 0.04 |
HLD = hepatolenticular degeneration; TCM = traditional Chinese medicine.
3.6.2. Clusters
In the CiteSpace software platform, we selected “Keyword” in “Node Types,” “Top 50%” for the level of most frequently occurring items from each slice in the selection criteria, “Pruning sliced networks” and “Pruning the merged networks” in Pathfinder, and other settings as default. The results showed that 13 clusters were generated; the top 5 clusters were “#1 Gandouling tablet,” “#2 Gandou Fumu decoction,” “#4 Gandou decoction,” “#5 Clinical Efficacy,” and “#8 Theoretical research” (Fig. 8). Details of the clusters are summarized in the following section:
Figure 8.
Cluster diagram of keywords in TCM pertaining to HLD. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.6.2.1. “#1 Gandouling tablet”
The Gandouling tablet was the main focus in this cluster that consisted of Dahuang (Radix et Rhizoma Rhei Palmati), Huanglian (Rhizoma coptidis), Danshen (Radix salviae miltiorrhiza), Jixueteng (Caulis spatholobi), Jianghuang (Rhizoma curcumae longae), and Ezhu (Rhizoma curcumae phaeocaulis). These have been suggested to be used for HLD with the syndrome of mixing damp heat and blood stasis, upper abdominal mass, scaly dry skin, a bitter taste or bad breath, constipation, dull color, ecchymosis, and a yellowish coating on the tongue.
Previous studies demonstrated that Gandouling tablets are beneficial for improving neurological functions including cognitive dysfunction, dysphagia, abnormal gait, and dystonia.[9–13] Gandouling was found to be effective in inhibiting apoptosis and anti-inflammation through the Protein Kinase R-like ER Kinase, Eukaryotic Translation Initiation Factor 2α, Dulbecco Minimum Essential Medium (CHOP), and the nuclear factor kappa-B signal pathway.[14] Xu et al[15] found that Gandouling had a clinical efficacy of up to 84.21% and was effective in reducing levels of TCM syndrome scores and indicators of liver function; its potential mechanism of action is related to regulation of the Protein Kinase R-like ER Kinase/eIF2a signal pathway.[16] In addition, Gandouling was found to improve mental symptoms and kidney function in patients.[17]
3.6.2.2. “#2 Gandou Fumu decoction”
This cluster mainly focused on the Gandou Fumu decoction, which includes Gouqizi (Fructus lycii), Tufuling (Rhizoma smilacis chinae), Sanqi (Radix notoginseng), Yujin (Radix curcumae wenyujin), Baishao (Radix paeoniae alba), and Chaihu (Radix bupleuri chinensis). It has the combined effect of nourishing the liver and tonifying the kidney while eliminating phlegm and removing blood stasis, and is mainly used for liver fibrosis in HLD.
Most of the current studies in this cluster involved animal experiments. Yang et al found that the Gandou Fumu decoction reduced liver function indicators, such as alanine aminotransferase, aspartate transaminase, total protein, albumin, and aspartate transaminase/alanine aminotransferase ratio, balancing the levels of superoxide dismutase with malonaldehyde, with only a few hepatic cells showing necrosis and denaturation.[18,19] This was shown to reduce levels of hyaluronic acid, laminin, type III procollagen peptide, type IV collagen and the expression of α-smooth muscle actin, collagen type 1 mRNA and related proteins in liver tissues in toxic milk mice (TX mile), playing an anti-fibrosis role by regulating the P13K/Art, JNK, and TGF-β1/Smad signal pathways.[20,21] A clinical trial showed that the Gandou Fumu decoction significantly improved clinical efficacy in HLD, as evidenced by 24-hour excretion of urinary copper, improved TCM syndrome scores, and anti-inflammatory and antioxidant indicators.[22]
3.6.2.3. “#4 Gandou decoction”
This is the earliest and longest cluster in the field of TCM pertaining to HLD. Based on the clinical characteristics and symptoms that most patients presented with, such as bitter taste, bad breath, a reddish tongue with yellowish coating, occasional upset, dry and bleeding gums, epistaxis, jaundice, and constipation, as well as the 19-item pathogenesis originally documented in Huang Di Nei Jing Su Wen, Yang considered chronic copper toxicosis the primary pathogenesis. Therefore, treatment consists of heat-clearing and detoxification, relieving the gallbladder, and promoting diuresis.
The Gandou decoction consists of Dahuang (Radix et Rhizoma Rhei Palmati), Huanglian (R coptidis), Huangqin (Radix scutellariae baicalensis), Banzhilian (Herba scutellariae barbatae), Chuanxinlian (Herba andrographis paniculatae), and Bixie (Dioscorea septemloba thund). It was proven to be more effective for HLD and recommended for patients in the early and maintenance therapy stages.[23] A large number of studies have proved the efficacy of integrating Gandou decoction and Western medicine to improve neurological and liver functions by enhancing the excretion of copper by the means of bile and, to a certain degree, possibly preventing the occurrence of leukopenia during treatment with copper chelating agents.[24,25]
3.6.2.4. “#5 Clinical efficacy”
“#5 Clinical efficacy” was the largest cluster that focused on clinical efficacy in the field of TCM pertaining to HLD. In the beginning, the main study designs were case reports and case series. Over the decades, as studies increased, cross-sectional studies, cohort studies, case-control studies, randomized control studies, systematic reviews, and meta-analyses were carried out.
The main treatment intervention was Chinese herbal medicines in various forms, such as decoction, powder, pill, tablet, and granules, among others. Gandou decoction,[26] Gandouling tablet,[27] Gandou Fumu decoction,[20] no. I Gandou tablet,[28] and Bushen Huoxue Huazhuo decoction[29] were classic preparations that were studied. The major outcome measures were the Global Assessment Scale, the Unified Wilson Disease Rating Scale, Goldstein grading, TCM syndrome score, 24-hour excretion of urinary copper, as well as ceruloplasmin and liver indicators. Additionally, there were clinical trials on acupuncture for HLD.[30,31]
3.6.2.5. “#8 Theoretical research”
This cluster mainly focused on the development of theoretical frameworks pertaining to HLD in TCM involving etiology and pathogenesis, investigation of TCM symptoms, treatment principles, and strategies. As per the principle “Internal wind always comes from fire,” Prof Renmin believed that heat-clearing methods were preferable in HLD.[32] With growing understanding, teams represented by Prof Wenming found that chronic copper toxicosis throughout the entire process of HLD, damp-heat, phlegm-turbidity, and blood-stasis caused by metabolism imbalances of Qi and blood were both etiological factors and pathologic effects. Therefore, Prof Wenming et al advocated treatment based on syndrome differentiation, distinguished by stages and types.[33]
Based on the above theoretical perspectives, researchers proposed treatment methods such as invigorating the spleen and removing dampness, maintaining internal organs, and removing blood stasis, as well as eliminating the turbidity of dampness and blood stasis.[34,35] For complications of liver fibrosis and renal injury in HLD, the feasibility of “micro-lumps in the liver” and “tonifying the kidney, removing blood stasis, and dissolving phlegm” in TCM were discussed.[25]
3.6.3. Timeline view
The timeline view mainly focused on outlining and relationships between clusters, showing TCM’s derivative track in HLD in each timeline. “#5 clinical efficacy” was always a research topic that received continuous attention in this field.
As advances in treatment of HLD using TCM continued, the clusters of “#1 Gandouling tablet,” “#2 Gandou Fumu Decoction,” and “#4 Gandoutang decoction” received uninterrupted attention. At the same time, there were fewer results in terms of “#8 Theoretical research.” Details are shown in Figure 9.
Figure 9.
Timeline view of keywords in TCM pertaining to HLD. HLD = hepatolenticular degeneration, TCM = traditional Chinese medicine.
3.6.4. Burst terms
We used the distribution of keywords with the strongest citation burst to predict frontiers in the field of TCM pertaining to HLD. The top 16 keywords with the strongest citation burst are shown in Figure 10. The strongest burst keywords were “traditional Chinese medicine,” “integrated medicine,” and “case report.” Hotspots changed over the decades, from case reports or case series studies on clinical efficacy that began in 1976 to clinical trials for prescriptions in 1997, to the promotion of treatment based on syndrome differentiation in 1998, to experimental research on effective prescriptions that were conducted since 2015. So far, studies on damp-heat syndrome, phlegm stasis syndrome, and the efficacy of prescriptions have been carried out.
Figure 10.
The top 16 keywords with the strongest citation burst.
4. Discussion
The use of bibliometrics helps to evaluate and even predict levels, frontiers, and trends.[36] In this review, we systematically summarized topics and frontiers of research in the field of TCM pertaining to HLD through multidimensional visual analysis. The field of treatment of HLD in TCM is currently undergoing a period of rapid development, characterized by the formation of stable networks of teams and cooperations as well as the establishment of practical theoretical bases, guidelines, and evaluation systems.
In general, indicators of progress in a subject are funding, researchers, and reports; the increase of the latter largely depends on the former. Studying the relationship of numbers over time can roughly reveal the characteristics and trends of subject development. Our results show that the number of annual publications has increased significantly in a steady upward trend, which indicates that the field of HLD treatment in TCM is growing rapidly and that the breakthrough achievements in this field have been widely applied, popularized, and applied in clinical treatment.
There has been a meteoric rise in the number of articles published on this topic due, in large part, to an increase in both funding and the number of scholars working in the field, as evidenced by the fact that 26.32% of total publications were from dissertations. The quality of published reports has significantly increased, as evidenced by the average (2023) comprehensive IF of the top 10 journals being 2.919. Moreover, factors such as interdisciplinarity, increased research collaboration and coordination, and improved means of information dissemination and publication technologies have all contributed to the rapid growth of research publications in this field.
An analysis of authors and institutions is recommended for identifying the number of institutions, measuring the reach of publications, and identifying core institutions and collaborations. According to our findings, 82.52% of the first authors were from Anhui province and mainly from 5 highly productive teams, with Wenming’s team and Renmin’s team being the most represented. In addition, The First Affiliated Hospital of the University of Science and Technology of China, the Anhui Medical University, and The First Affiliated Hospital of Guangdong Pharmaceutical College, and other institutions have formed smaller cooperation networks or separate nodes. Although there were stable networks of teams and coauthors, the restricted regional characteristics of cooperation were obvious, and large-scale studies have not yet been undertaken. To encourage further research and development in this area, we suggested bolstering the integration of resources from different provinces and institutions and carrying out cross-regional clinical collaboration.
Keywords reflect the main topics of study, and consequently, keyword analysis systematically indicates the status, hotpots, and trends in TCM relevant to HLD. We found that clinical efficacy has always been a continuous research topic in this field, and with the further development of studies, it has gradually evolved into multidisciplinary modes of diagnosis and treatment. Gandou decoction,[37] no. IV Gandou decoction,[38] Gandouling tablet,[39] Gandou Fumu decoction,[22] Bushen Huatan Quyu decoction,[40] and Yiqi Jianpi Huoxue decoction[41] have been found effective for neurological symptoms, liver fibrosis, reproductive damage, and splenectomy, and a large number of studies have been conducted regularly.
Based on our results, we found that studies of TCM syndromes were mostly observational in nature, lacking extended study, long-term follow-up, a large sample, and a wide-region epidemiological investigation. To a certain degree, this has restricted the process of syndrome differentiation and treatment, standardized diagnosis and treatment, and the discovery of new drugs.
Although “early detection and treatment” in clinical practice has enabled patients with HLD and other movement disorders to maximize benefits, clinical efficacy, drug safety, and survival analysis of the long-term maintenance strategies of integrative medicines for HLD have not been carried out. In the future, higher-quality, larger-sample, long-term follow-up randomized controlled trials or real-world studies need to be carried out to identify the most appropriate patients and what constitutes the most effective prescriptions to provide reliable TCM evidence for HLD.
In our review, we have attempted to uncover frontiers and trends in the field of TCM pertaining to HLD by using CiteSpace and VOSviewer software. Although we reviewed as many study reports as possible, we were not able to analyze reports in foreign languages due to software limitations. At the same time, our findings were also limited to a certain extent as we did not take up citation analysis, which is an effective method to study general trends in literature aging and data utilization.[42] Finally, the connotations of frontiers and bibliometric trends need more intensive analysis.[43]
5. Conclusion
The field of TCM pertaining to HLD is currently in a stage of rapid development, energized by the formation of stable networks of teams and collaborations. However, large-scale collaboration has still not been fructified, and studies of TCM syndromes are relatively limited. Deficiencies in this field should be addressed in the future to further explore the potential benefits of integrative treatment for HLD.
Author contributions
Conceptualization: Zhuang Tao, Wenming Yang, Meixia Wang.
Formal analysis: Zhuang Tao, Fei Wang, Zhenzhen Jiang, Chi Wang, Chao Jiang, Sheng Ye.
Writing—original draft: Zhuang Tao, Meixia Wang.
Data curation: Chi Wang, Chao Jiang, Sheng Ye.
Writing—review & editing: Wenming Yang, Meixia Wang.
Funding acquisition: Zhuang Tao, Meixia Wang.
Abbreviations:
- HLD
- hepatolenticular degeneration
- TCM
- traditional Chinese medicine
This work was supported by Young Qihuang Scholars Training Plan (No. 2022.256); Anhui Provincial Natural Science Foundation (No. 2308085QH291); the Transformation Project of Anhui Clinical Medical Research (No. 202204295107020001); the Anhui Reserved Excellent Talent Plan (No. 2022.04); Anhui Province Scientific Research Compilation Plan Project, 2023 (Key Projects) (No. 2023AH050798, 2023AH050765); Health Research Project of Anhui Province in 2023 (No. AHWJ2023A30137).
The authors declare that they have no conflict of interest regarding this work.
The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.
How to cite this article: Tao Z, Wang F, Jiang Z, Wang C, Jiang C, Ye S, Yang W, Wang M. A bibliometric analysis of hepatolenticular degeneration research in traditional Chinese medicine using CiteSpace and VOSviewer: A study protocol for systematic review. Medicine 2024;103:49(e40781).
Contributor Information
Zhuang Tao, Email: zhuangtaodr@21cn.com.
Fei Wang, Email: meixiadrwang@outlook.com.
Zhenzhen Jiang, Email: chaojiangdr@21cn.com.
Chi Wang, Email: meixiadrwang@outlook.com.
Chao Jiang, Email: chaojiangdr@21cn.com.
Sheng Ye, Email: shengyedr@21cn.com.
Wenming Yang, Email: wenmingyangdr@21cn.com.
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