Unveiling the Q-Markers of Viscum coloratum (Kom.) Nakai: Enhancing Clinical Efficacy for the Treatment of Rheumatoid Arthritis.

Viscum coloratum (Kom.) Nakai, a traditional Chinese medicine for rheumatoid arthritis, faces emergency challenges in clinical quality control due to inconsistent formulations and the lack of standardized evaluation criteria. To resolve this issue, this study established a systematic quality control framework for Viscum coloratum (Kom.) Nakai based on the concept of quality markers (Q-markers) in traditional Chinese medicine (TCM). Following TCM Q-markers principles, 10 potential candidates identified in our previous study were selected based on the key criteria, including effective separation and high abundance. A comprehensive five-dimensional evaluation system, for assessing reproducibility, content, stability, relevance, and effectiveness, was developed using an integrated analytic hierarchy process (AHP) and technique for order preference by similarity to ideal solution (TOPSIS) methodologies. Data normalization and weighted scoring facilitated the construction of a "spider-web" model for multicriteria decision-making, with a relative proximity threshold (≥ 0.409) applied to identify the most suitable Q-markers. Finally, through this approach, four candidates were ultimately selected as Q-markers for Viscum coloratum (Kom.) Nakai: viscumneoside III (VIS), homoeriodictyol-7-O-β-glucoside (HOG), oleanolic acid (OLA), and chlorogenic Acid (CHL). This systematic approach enhances Viscum coloratum (Kom.) Nakai quality control and provides insights for TCM standardization.