Chinese Medicine Practitioners Research Articles

BuqiTongluo Granule for Ischemic Stroke, Stable Angina Pectoris, Diabetic Peripheral Neuropathy with Qi Deficiency and Blood Stasis Syndrome: Rationale and Novel Basket Design.

Background: BuqiTongluo (BQTL) granules are herbal phenotypic drugs for Qi deficiency and blood stasis (QDBS) syndrome. Its discovery relied primarily on knowledge of observable phenotypic changes associated with diseases. Although BQTL granules have been widely advocated by Chinese Medicine (CM) practitioners, its use lacks empirical support. Aim of the study: In this basket trial, the efficacy of BQTL granules in multiple diseases that have the QDBS syndrome in common will be compared with placebo. Materials and Methods: The BuqiTongluo granule for Qi deficiency and blood stasis syndrome (BOSS) study is a basket herbal trial (ClinicalTrials.gov, NCT04408261). It will be a double-blinded, randomized, placebo-controlled, parallel, multicenter, clinical trial. In total, 432 patients (1:1:1 ischemic stroke, stable angina pectoris, and diabetic peripheral neuropathy), who meet the operationalized diagnostic criteria for QDBS syndrome, have been recruited and randomized in a ratio of 1:1 to receive 6 weeks’ treatment with BQTL granules or placebo. The primary outcome is the change in the QDBS syndrome score at week 6 from baseline. Secondary outcomes include objective outcome measures for the three diseases and adverse events. Omics will help to understand these responses by molecular events. Conclusion: QDBS syndrome is a common phenotypic marker that was hypothesized to predict whether patients with multiple diseases would respond to this targeted therapy. No previous basket trial has assessed the potential efficacy of an herbal intervention for multiple diseases. The unique promise of the trial is its ability to exploit a disease phenotype to discover novel treatments for three diseases for which the root cause is unknown, complex, or multifactorial, and for which scientific understanding is insufficient to provide valid molecular targets.

Apprentices in traditional Chinese medicine: the process of becoming a national policy

At the beginning of the New China, the first National Health Administration Conference and the first National Health Conference established the health administration policies of the New China, but ignored the training of Chinese medicine successors. After 1954, the policy towards Chinese medicine changed gradually. In 1956, the Ministry of Health issued the Instructions on Carrying out the Work of Apprentices with Chinese Medicine, and developed the National Plan for Apprentices with Chinese Medicine from 1956 to 1962 (Draft). Although their initial implementation did not go smoothly, it was still one of the important policy measures to train and cultivate new practitioners of traditional Chinese medicine (TCM) and ensure TCM successors in the New China.

Evaluation of the quality of YouTube videos on traditional Chinese medicine and inflammatory arthritis

IntroductionYouTube is used by patients to obtain healthcare related information, but its quality of videos is controversial. We aimed to assess the reliability and quality of YouTube videos as a source of patient education about Traditional Chinese Medicine for inflammatory arthritis. MethodsWe searched YouTube with the following keywords (in English and Mandarin): “traditional Chinese medicine”, “rheumatoid arthritis”, “ankylosing spondylitis”, “spondyloarthritis”, “psoriatic arthritis” and “inflammatory arthritis”. We excluded videos that were neither in English nor Mandarin, irrelevant or duplicates. We assessed video reliability and quality using the modified 5-point DISCERN tool and 5-point Global Quality Scale respectively. We categorized videos as having useful information, misleading information or personal experience. ResultsOut of the 1032 videos obtained from the search, we included 108 videos for analysis. We categorized 36 (33.33%) videos as providing useful information, 50 (46.30%) as misleading information and 22 (20.37%) as personal experience. Misleading videos gave partially accurate or inaccurate explanations and some were used for promotional purposes, with minimal information on Traditional Chinese Medicine. Videos uploaded by news sources had the highest reliability and quality, with 73.08% containing useful information. ConclusionThere is a lack of useful videos about Traditional Chinese Medicine for inflammatory arthritis on YouTube, with about half containing incorrect information. Rheumatologists and Traditional Chinese Medicine practitioners should actively enquire and discuss with patients about their online search, to guide patients in discriminating useful videos from misleading ones. Both healthcare professionals can collaborate to produce videos with content of a higher quality.

Revival or Innovation? Chinese medicine at the crossroads of professionalization in Hong Kong

Based on 67 in-depth interviews of Chinese medicine (CM) Practitioners in Hong Kong, this paper reviews the ongoing debate within Hong Kong's CM community between the two pathways of professionalization: revival of the Chinese traditional knowledge or innovate by incorporating biomedical principles. Following earlier efforts to apply social movement perspectives onto the study of professionalization, we examine how segments of CM practitioners strive to forge divergent collective identities in their quest for professional status along three analytical dimensions: consciousness, boundary and strategies. This paper deepens our understanding of the professionalization of complementary and alternative medicines by documenting the construction of distinctive sub-identities not just over how the modality should interact with the mainstream biomedicine but also how to interpret the essence of their own practice. It shall also account for the emergence of the schism of professional identities in Hong Kong as distinctive results of the institutional configuration of the Hong Kong medical system under the One Country Two Systems, shaped by the twin forces of biomedical dominance locally as well as the thrust towards integrative medicines in Mainland China.

Common mechanism of Citrus Grandis Exocarpium in treatment of chronic obstructive pulmonary disease and lung cancer

Objective“Same treatment for different diseases” is a unique treatment strategy in traditional Chinese medicine. Two kinds of malignant respiratory diseases endanger human health-chronic obstructive pulmonary disease (COPD) and lung cancer. Citrus Grandis Exocarpium (Huajuhong in Chinese, HJH), a famous herbal, is always applied by Chinese medicine practitioners to dispersion the lung to resolve phlegm based on “syndrome differentiation and treatment” theory. However, the common mechanism for HJH’s treatment of COPD and lung cancer is not clear. MethodsIn this study, based on network pharmacology and molecular docking technology, the common mechanism of HJH in the treatment of COPD and lung cancer was studied. The active ingredients and related targets of HJH were integrated from TCMSP, BATMAN-TAM, STP, and Pubchem databases. The standard names of these targets were united by UniProt database. Targets of COPD and lung cancer were enriched through GeneCards, NCBI (Gene), Therapeutic Target Database, and DisGeNET (v7.0) databases. Then the intersection targets of HJH and diseases were obtained. The STRING network and the Cytoscape 3.7.2 were used to construct PPI network, the DAVID database was used to perform GO and KEGG analysis. Then Cytoscape 3.6.1 was used to build “ingredient-target-signal pathway” network. Finally, AutoDock 1.5.6 software was used to perform molecular docking of key proteins and molecules. ResultsEleven active ingredients in HJH were obtained by searching the database, corresponding to 184 HJH-COPD-lung cancer targets intersection. The results of biological network analysis showed that naringenin, the active component in HJH, could mainly act on target proteins such as AKT1, EGFR. Then through positive regulation of vasoconstriction and other biological processes, naringenin could regulate estrogen signaling pathway, VEGF signaling pathway, HIF-1 signaling pathway, ErbB signaling pathway, PI3K-Akt signaling pathway to play an important role in the treatment of both COPD and lung cancer. ConclusionNetwork pharmacology was employed to systematically investigate the active ingredients and targets of HJH in treatment of COPD and lung cancer. And then, the common pharmacodynamic network of HJH for the two malignant respiratory diseases was firstly described. Furthermore, naringenin was proved to strongly bind with AKT1 and EGFR. It may provide the scientific basis for understanding the “Same treatment for different diseases” strategy in traditional Chinese medicine and inspirit subsequent drug discovery for COPD, lung cancer and other malignant lung diseases.

Professor Ruixia Pei’s Experience in Treating Hyperthyroidism

In this article, we summarize the clinical experience of Professor Ruixia Pei, a famous traditional Chinese medicine practitioner in Shaanxi Province, China, in treating hyperthyroidism. The etiology and pathogenesis, syndrome differentiation, and medication experience are introduced in detail. This paper summarizes the advantages of Professor Pei’s methods of syndrome differentiation and treatment of hyperthyroidism. This may help enrich the clinical treatment of hyperthyroidism, and provide some diagnosis and treatment ideas.

Barriers and facilitators to promoting evidence uptake in Chinese medicine: a qualitative study in Hong Kong

BackgroundIn response to the World Health Organization’s recommendation, policy makers have been adopting evidence-based healthcare approach to promote the development of traditional, complementary and integrative medicine (TCIM) into Hong Kong’s health system. Disseminating synopses of clinical evidence from systematic reviews or randomized trials is regarded as a potentially effective strategy to promote evidence uptake. The study aimed to identify barriers and facilitators to implementing this strategy among Hong Kong Chinese medicine practitioners (CMPs).MethodsTwenty-five CMPs aged under 45 years and trained in Hong Kong after reunification with China in 1997 were interviewed individually. Four clinical evidence synopses of randomized trials and systematic reviews on Chinese medicine interventions were presented, and CMPs were asked to comment on their applicability in routine practice. The Consolidated Framework for Implementation Research (CFIR) was applied to guide interview and analysis.ResultsThe barriers included: i) CMPs’ perceived difficulties in applying complex evidence in decision-making and ii) inadequate training and limited consultation time. The facilitators were i) availability of publicly accessible and user-friendly synopses, ii) formation of community of evidence-based practice among CMPs with input from key opinion leaders, iii) opportunity for interprofessional collaborations with conventional healthcare providers, and iv) patients’ demand for evidence-based clinical advice. Besides, i) CMPs’ knowledge and beliefs in evidence-based healthcare approach, ii) presentations of evidence-based information in the synopses, and iii) clinical decision making as influenced by quality of evidence reported acted as both barriers and facilitators.ConclusionsThis CFIR-based qualitative study investigated how the World Health Organization recommendation of promoting evidence use in routine practice was perceived by CMPs trained in Hong Kong after reunification with China in 1997. Key barriers and facilitators to applying evidence were identified. Such results will inform tailoring of implementation strategies for promoting evidence uptake, in the context of a well-developed health system dominated by conventional medicine.

A cross-sectional study of traditional Chinese medicine practitioner\u2019s knowledge, treatment strategies and integration of practice of chronic pelvic pain in women

BackgroundChronic pelvic pain (CPP) in women is persistent, intermittent cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months. Traditional Chinese Medicine (TCM) is a popular treatment option for women’s health conditions, but little is known about how treatment for CPP is delivered by TCM practitioners. The aim of this survey was to explore practitioners understanding and treatment of women with CPP, and how they integrate their management and care into the health care system.MethodAn online cross-sectional survey of registered TCM practitioners in Australia and New Zealand between May and October 2018. Survey domains included treatment characteristics (e.g. frequency), evaluation of treatment efficacy, referral networks, and sources of information that informed clinical decision making.ResultsOne hundred and twenty-two registered TCM practitioners responded to this survey, 91.7% reported regular treatment of women with CPP. Treatment decisions were most-often guided by a combination of biomedical and TCM diagnosis (77.6%), and once per week was the most common treatment frequency (66.7%) for acupuncture. Meditation (63.7%) and dietary changes (57.8%) were other commonly used approaches to management.The effectiveness of treatment was assessed using multiple approaches, most commonly pain scales, (such as the numeric rating scale) and any change in use of analgesic medications. Limitations to TCM treatment were reported by over three quarters (83.7%) of practitioners, most commonly due to cost (56.5%) and inconvenience (40.2%) rather than safety or lack of efficacy. Sources informing practice were most often Integration within the wider healthcare system was common with over two thirds (67.9%) receiving referrals from health care providers.ConclusionTCM practitioners seeing women with various CPP symptoms, commonly incorporate both traditional and modern diagnostic methods to inform their treatment plan, monitor treatment progress using commonly accepted approaches and measures and often as a part of multidisciplinary healthcare for women with CPP.

Toxicity Effects of Chinese Herbal ‘Five-seeds’ Formulation on Human Kidney HEK-293 and Chang Liver Cells

‘Five-seeds’ formulation (Lycium barbarum, Cuscuta chinensis Lam, Rubus idaeus, Schisandra chinensis, Plantago asiatica) have been used by Chinese medicine practitioner for the treatment of male infertility for a long time. The present study aims to investigate the potential toxicity effects of the individual herb used in ‘five-seeds’ formulation and as a concoction on human HEK293 and Chang liver cells, using cell viability MTT assay and SubG1 flow cytometry analysis. Percentage of cell viability from samples (1, 25, 50, 75, 100 mg/mL) decreased as the concentration increased. Half maximal inhibitory concentration (IC50) values indicated that Cuscuta chinensis, Rubus idaeus and Schisandra chinensis are among the most toxic herb samples on HEK293 cells, with the IC50 values less than 22 mg/mL. On the other hand, Rubus idaeus (IC50 value 20.1 mg/mL) and Schisandra chinensis (IC50 value 17.8 mg/mL) were found to have the highest toxicity effect on Chang liver cells. Plantago asiatica and Lycium barbarum (IC50 more than 67 mg/mL) are the least toxic herbs tested on both human HEK293 kidney and Chang liver cells. ‘Five-seeds’ herbal formulation had IC50 values of 33 mg/mL and 38.5 mg/mL on HEK293 and Change liver cells respectively, suggesting that ‘five seeds’ formulation has modulated the toxicity effect of the mixed herbs used in this formula. Apoptotic cells in SubG1 phase were also found to be significantly low for HEK293 (13.08%) and Chang liver cells (10.17%) with the treatment of 25 mg/mL of ‘five seeds’ formulation. Toxicity effect of five-seeds’ herbal formulation has seemingly been modulated when all the five herbs mixed as a concoction, and potentially non-toxic as a concoction to HEK293 kidney and Chang liver cells. However, more investigations should be done to draw a solid conclusion.

Three-Dimensional Arterial Pulse Signal Acquisition in Time Domain Using Flexible Pressure-Sensor Dense Arrays.

In this study, we developed a radial artery pulse acquisition system based on finger-worn dense pressure sensor arrays to enable three-dimensional pulse signals acquisition. The finger-worn dense pressure-sensor arrays were fabricated by packaging 18 ultra-small MEMS pressure sensors (0.4 mm × 0.4 mm × 0.2 mm each) with a pitch of 0.65 mm on flexible printed circuit boards. Pulse signals are measured and recorded simultaneously when traditional Chinese medicine practitioners wear the arrays on the fingers while palpating the radial pulse. Given that the pitches are much smaller than the diameter of the human radial artery, three-dimensional pulse envelope images can be measured with the system, as can the width and the dynamic width of the pulse signals. Furthermore, the array has an effective span of 11.6 mm—3–5 times the diameter of the radial artery—which enables easy and accurate positioning of the sensor array on the radial artery. This study also outlines proposed methods for measuring the pulse width and dynamic pulse width. The dynamic pulse widths of three volunteers were measured, and the dynamic pulse width measurements were consistent with those obtained by color Doppler ultrasound. The pulse wave velocity can also be measured with the system by measuring the pulse transit time between the pulse signals at the brachial and radial arteries using the finger-worn sensor arrays.

Efficacy and safety of Chinese herbal medicine Jianpi formulas for atopic dermatitis: Evidence from 11 randomized controlled trials.

Jianpi formulas have been widely used to treat atopic dermatitis (AD) by traditional Chinese medicine (TCM) practitioners, but the efficacy and safety need further evaluation. A meta-analysis of randomized controlled trials was performed to assess the efficacy and tolerability of Jianpi formulas for AD. We searched the following databases up to October 2020: PubMed, Embase, China National Knowledge Infrastructure database (CNKI), and Wanfang database. All randomized controlled trials (RCTs) evaluated Jianpi formulas add-on effect for AD were included for meta-analysis. The primary outcome was minor remission. Secondary outcomes include complete remission, marked remission, and decrease of SCORAD. Totally eleven studies were included. Nine studies were included in qualitative analysis and seven were included in quantitative analysis. The common herbs were poria, glycyrrhiza uralensis, rhizoma atractylodis, atractylodes macrocephala, and semen coicis. The Jianpi formulas add-on therapy showed consistent higher effectiveness rate in complete remission (RR1.528, 95%CI 1.176-1.984. p<0.01; Q=2.31, I2 =0%), marked remission (RR 1.388, 95% CI 1.234-1.562. p<0.01; Q=3.682, I2 =0%), and minor remission (RR 1.170, 95% CI 1.105-1.239, p<0.01; Q=14.355, I2=44.27%). The decrease of the scoring atopic dermatitis (SCORAD) in Jianpi formulas was significantly higher than in control group (SMD=0.671, 95% CI 0.018 to 0.937). Jianpi formulas were generally well tolerated, with no significantly increased risk of adverse events (AE). The combinations of Jianpi formulas showed moderate positive add-one effects in AD patients. Further well-designed clinical trials are needed to evaluate long-term effect of this therapy.

China's Legalization of Domestic Rhino Horn Trade: Traditional Chinese Medicine Practitioner Perspectives and the Likelihood of Prescription

Despite the international ban on the trade of rhino horn that has been in place since 1977, persistent demand for horn in Asia has driven a spike in poaching over the past decade. This has embroiled the conservation community in a debate over the efficacy of banning trade relative to other solutions. Proposals for trade to be legalized and supplied through the dehorning of live rhinos or the production of synthetic horn are contentious. The need for empirical research into the potential impacts of legalization on demand was made more urgent in 2018 when China publicized its intentions to reopen its domestic trade and permit the use of rhino horn in medical treatment. In this study, we interviewed 84 Traditional Chinese Medicine (TCM) practitioners in the Chinese province of Guangdong. While 58 (69.05%, n = 84) of our interviewees were in favor of trade legalization, only 32 (38.10%, n = 84) thought it likely that trade legalization would cause them to increase their prescription of rhino horn over current levels. This is probably because clinical cases in which rhino horn is medically appropriate are uncommon. We also found that 33 (39.29%, n = 84) practitioners were open to using synthetic horn for patient treatment, which has implications for the viability of synthetic horn as a conservation tool. This research contributes empirical insight to advance the discourse on rhino horn trade policy.

Chinese medicine practitioner turnover rate and the development of Chinese medicine in Hong Kong, China

To establish that the Hong Kong Special Administrative Region (HKSAR) government is actively promoting Chinese medicine (CM) and to examine turnover rate of Chinese medicine practitioners (CMPs) in Hong Kong, China in light of this governmental push. This study covered two major areas: reviewing CM development in Hong Kong, and assessing the turnover rate of CMPs in Hong Kong. The first part of the paper is a historical review. The investigation of turnover rate had two sections. Section 1, quantitative method, involved online questionnaires; Section 2, qualitative method comprised interviews with CMPs from different types of CM clinics to ascertain the reasons for the turnover among CMPs. A total of 123 online questionnaires were received in Section 1 (55 from male CMPs; 66 from female CMPs; 2 respondents were unwilling to disclose their sex). The proportion of CMPs who had resigned in 2018–19 was 22.8% (28), of whom 5.7% (7) had resigned twice in one year. The rates of resignation in 3 years and 5 years were up to 40.7% (50) and 56.9% (70), respectively. Six CMPs were interviewed in Section 2. Young CMPs were more likely to resign than seniors. The large gap between actual salary and expectations appeared to be the main reason for the high rate of resignation. HKSAR government keenly desires to promote CM in Hong Kong, however, high turnover rate of CMPs was detected even under this positive governmental support. There is an urgent need to conduct a more representative study of the reasons for the inclination of CMPs in Hong Kong. The study highlights an important issue in CM development, and these results should remind different stakeholders in the CM industry and the government that CMPs need better career prospects and support in various areas.

Therapeutic potential of curcumin indiabetic retinopathy (Review).

Diabetic retinopathy (DR) is a type of retinal microangiopathy caused by diabetes mellitus. It has become the leading cause of blindness among working individuals worldwide. DR is becoming increasingly common among younger diabetic patients and there is a need for lifelong treatment. The pathogenic mechanisms of DR are influenced by a number of factors, such as hyperglycemia, hyperlipidemia, inflammatory response and oxidative stress, among others. Currently, the treatment methods for DR mainly include retinal photocoagulation, vitrectomy, or anti-vascular endothelial growth factor (VEGF) therapy. However, these methods have some disadvantages and limitations. Therefore, it is a matter of great interest and urgency to discover drugs that can target the pathogenesis of DR. Since ancient times, traditional Chinese medicine practitioners have accumulated extensive experiences in the use of Chinese herbal medicine for the prevention and treatment of diseases. In the theory of traditional Chinese medicine, curcumin has the effects of promoting blood circulation and relieving pain. A number of studies have also demonstrated that curcumin has multiple biological activities, including exerting anti-apoptotic, anti-inflammatory, antioxidant and antitumor properties. In recent years, studies have also confirmed that curcumin can prevent a variety of diabetic complications, including diabetic nephropathy (DN). However, the preventive and curative effects of curcumin on DR and its mechanisms of action have not yet been fully elucidated. The present review aimed to explore the therapeutic potential of curcumin in diabetes mellitus and DR.

The Introduction and Localisation of Traditional Chinese Medicine in Malaysia

This thesis discusses how traditional Chinese medicine was introduced to Malaysia. History records show that traditional Chinese medicine was first introduced to Malaysia in the year 1405 while 1796 saw the establishment of Malaysia's first Chinese medicine shop. With the popularization of Chinese medicine, Chinese medicine education and organizations were established. Traditional Chinese Medicine has gradually been recognized by the Malaysian government due to the efforts of the practitioners of traditional Chinese medicine. In 2004, the Traditional and Complementary Medicine Department was established at the prestigious National Cancer Institute to improve quality of life as well as provide opportunities for cure to cancer patients.

Project Pulse: A Dance Research Experience

ABSTRACT The research outlined in this article offers a systematic training methodology for students and licensed Traditional Chinese Medicine (TCM) practitioners to learn the clinical art and science of pulsology through dance. One of the greatest hurdles in learning pulse palpation is a TCM practitioner’s inability to feel the pulse with a degree of certainty that adds value in a clinical setting. Through inter-operator reliability testing, our research indicates that if practitioners learn and repeat pre-choreographed movements that represent pulse imagery, there is increased agreement amongst the group as to what pulses are being expressed in the bodies of patients. The implications of our research are that TCM practitioners are able to increase their ability to feel pulses in their patients by dancing the pulses, thus making more informed diagnoses in a clinical setting.

The Introduction and Localisation of Traditional Chinese Medicine in Malaysia

This thesis discusses how traditional Chinese medicine was introduced to Malaysia. History records show that traditional Chinese medicine was first introduced to Malaysia in the year 1405 while 1796 saw the establishment of Malaysia's first Chinese medicine shop. With the popularization of Chinese medicine, Chinese medicine education and organizations were established. Traditional Chinese Medicine has gradually been recognized by the Malaysian government due to the efforts of the practitioners of traditional Chinese medicine. In 2004, the Traditional and Complementary Medicine Department was established at the prestigious National Cancer Institute to improve quality of life as well as provide opportunities for cure to cancer patients.

Professionalism in traditional Chinese medicine (TCM) practitioners: a qualitative study

BackgroundMedical professionalism is important for establishing public trust in doctors. Its definition is culture-sensitive. However, no research has explored medical professionalism in Traditional Chinese Medicine (TCM) practitioners. This study aims to (a) establish the domains of professionalism in TCM practitioners in Singapore, and to (b) compare the domains of professionalism of practitioners trained in TCM and practitioners trained in conventional medicine.MethodsData for this qualitative study was collected through in-depth interviews (IDIs) with TCM practitioners. IDIs were audio-recorded and transcribed verbatim. Thematic analysis was conducted by two independent coders using the Professionalism Mini-Evaluation Exercise (P-MEX) as a framework. The domains of professionalism in TCM and conventional medicine were then compared, using data from a similar study on professionalism in practitioners trained in conventional medicine.ResultsA total of 27 TCM practitioners (40.7% male) participated in this study. The four domains of professionalism in the P-MEX, namely doctor-patient relationship skills, reflective skills, time management and inter-professional relationship skills, and two new sub-domains, “communicated effectively with patient” and “demonstrated understanding and integrated with conventional medicine”, were relevant to TCM practitioners. This is largely similar to that of practitioners trained in conventional medicine, with a few differences, including “ensured continuity of care” and “used health resources appropriately”.ConclusionThe domains of professionalism in TCM practitioners were established and they are similar to that of practitioners trained in conventional medicine. This study is the first to define medical professionalism in TCM practitioners. Findings will provide guidance on the education of professionalism in TCM practitioners.

Use of Questioning between Traditional Chinese Medicine Practitioners and Patients to Realize TCM Philosophy: Holism, Five Elements and Yin-Yang in the Context of Doctor–Patient Communication

ABSTRACT Adopting a broad discourse analytic approach, the present study investigates authentic interactions between Traditional Chinese Medicine (TCM) practitioners and patients in Hong Kong so as to identify specific characteristics of communication in this context, particularly how patients develop and internalize their understanding of illnesses in terms of ‘balance’ via the question–answer (Q-A) routine. Findings can improve our understanding of the role of doctor-patient negotiations and the effects of a practitioner’s questioning style on the patients’ ability to ‘internalize’ their understanding of their body conditions in the TCM context. While questioning is considered an important communication technique when soliciting patients’ problems during consultations, its value in terms of understanding patients’ concerns about issues other than their illnesses has not been explored. Based on consultations of 8 hours in length, our study finds that the use of questions not only can create a space wherein patients can discuss their illnesses and primary concerns, but also enable patients to gain a holistic understanding of their body conditions. This paper informs readers about the techniques that TCM practitioners can use to structure their conversations while delivering patient-centered care, including lexical, grammatical, and cultural resources.

The sequel to COVID-19: the antithesis to life

The sequel to COVID-19: the antithesis to life