Chinese Medicine Clinical Practice Research Articles

The application of situational heuristic teaching method in the teaching of acupuncture and moxi-bustion

Objective Aiming at the characteristics of the course of acupuncture and massage, to discuss the application of Situational heuristic teaching. Methods 60 undergraduate students in Grade Four of Jiangxi University of Traditional Chinese Medicine(clinical practice)were even divided into 2 groups, that was situational teaching group(the experimental group)and the traditional teaching group(control group). The students in the experimental group received basic theory course of 30 hours, 60 hours in the course of situational teaching. The clinical cases of teaching were carefully designed according to the simu-lated hospital scene in each chapter, including large cases, acupuncture and massage therapy program, which were conducted between teachers and students through interactive and positive research and other forms. In the control group the teachers taught the content to students in class for full 90 hours in accor-dance with the requirements of the teaching syllabus. Taking objective theoretical examination, subjective questionnaire survey, and subjective clinical return visit questionnaire scores as indicators the difference of the two kinds of teaching methods were compared and statistical analysis was carried out by SPSS 19.0 software, chi square test and t test. Results By comparison of objective theoretical examination results of two groups of subjects, the number of good students in the experimental group was 10, and the number of outstanding students was 7, with an average of(80.63±1.35)points. In the control group, the number of good students was 9, the number of outstanding students was 6, with the average score of(80.54±1.32), and the average score of the objective theory test scores were not statistically significant(P>0.05). The learning satisfaction of the students in the experimental group was(3.91±0.29). Students in the experimental group thought situation heuristic teaching was conducive to professional development(3.23 ± 0.39), to improving the learning quality(3.68 ± 0.72), clinical thinking culture(4.11±0.24), clinical ability(3.72±0.27), clinical physician-patient communication skills(3.28±0.79), basic clinical skills(3.48±0.42)points, with teaching satisfaction(4.19±0.25), which were all higher than the control group, and the difference was statistically significant(P<0.05). Conclusion Situational heuristic teaching method is better than the traditional teach-ing method in stimulating students' learning enthusiasm, innovation ability, cultivating professional interest and cultivating students' clinical practice ability. The teaching practice of teachers should give full play to the advantages of the method and improve the teaching effect, which is worthy of further research and pro-motion. Key words: Situational heuristic teaching; Acupuncture and moxibustion; Application

Evidence-based Chinese medicine clinical practice guideline for stomach pain in Hong Kong.

Stomach pain in Chinese medicine (CM) is a very common disorder in clinical practice and it has been listed as one of the pilot three conditions in Hong Kong to develop evidence-based CM clinical practice guidelines (CM CPGs). The aim of this stomach Pain CPG is to summarize the treatment methods of stomach pain with CM and evaluate reasonably, then to guide local licensed CM practitioners and provide beneficial reference for social medical decision makers and patients. In this manuscript, we defined stomach pain in CM and the category of chronic gastritis in Western medicine. The clinical manifestation, CM pattern classification, and CM intervention including herbal medicine treatment based on pattern differentiation, symptomatic treatment, acupuncture treatment, regulation and nursing were illustrated.

Study on Quality Assessment ofTraditional Chinese Medicine Clinical Practice Guideline for Incomplete Spinal Cord InjuryBased on AGREE �� Instrument

Study on Quality Assessment of<i>Traditional Chinese Medicine Clinical Practice Guideline for Incomplete Spinal Cord Injury</i>Based on AGREE �� Instrument

Thinking of the safety application of TCM By You Gu Wu Yun, A Chinese Ancient Medicine Application Principle

Background: You Gu Wu Yun (有故无殒), a Chinese ancient medicine application principle, has played an important role in Traditional Chinese Medicine (TCM) clinical practice so far.Materials and Methods: It emphasized that disease, medicine and treatment method were interconnecting and the relationship among these three aspects should be handled reasonably. The major factors (including organism status, medicine source, medicine processing, compatibility of medicines, dose and course, dosage form) under the three aspects which have a more important and direct influence on the medicine clinical effect should be considered seriously in the TCM application.Results: However, it was analyzed that most of side effects of TCM may be due to the incorrect application, which violated this principle to a certain degree. In order to help people to understand the safety and toxicity of TCM objectively and provide a rational guidance for the safe and effective application of TCM, we will introduce the concept of You Gu Wu Yun and discuss these factors having influence on medicine in this review. An example will be shown in order to clarify how these factors work in medicine.Conclusions: As a unique medical system, TCM has its own theoretical basis and treatment principle. It stresses syndrome differentiation, namely personalized medicine. Therefore, it is critical to handle the relationship among disease, medicine and treatment for safe and effective medicine application.Key words: You Gu Wu Yun; TCM application; Safety; Efficacy; Factors

THINKING OF THE SAFETY APPLICATION OF TCM BY YOU GU WU YUN, A CHINESE ANCIENT MEDICINE APPLICATION PRINCIPLE

Background: You Gu Wu Yun (有故无殒), a Chinese ancient medicine application principle, has played an important role in Traditional&#x0D; Chinese Medicine (TCM) clinical practice so far.&#x0D; Materials and Methods: It emphasized that disease, medicine and treatment method were interconnecting and the relationship among these&#x0D; three aspects should be handled reasonably. The major factors (including organism status, medicine source, medicine processing, compatibility&#x0D; of medicines, dose and course, dosage form) under the three aspects which have a more important and direct influence on the medicine clinical&#x0D; effect should be considered seriously in the TCM application.&#x0D; Results: However, it was analyzed that most of side effects of TCM may be due to the incorrect application, which violated this principle to a&#x0D; certain degree. In order to help people to understand the safety and toxicity of TCM objectively and provide a rational guidance for the safe and&#x0D; effective application of TCM, we will introduce the concept of You Gu Wu Yun and discuss these factors having influence on medicine in this&#x0D; review. An example will be shown in order to clarify how these factors work in medicine.&#x0D; Conclusions: As a unique medical system, TCM has its own theoretical basis and treatment principle. It stresses syndrome

Novel discoveries on relationship of the golden spiral and the Hetu and Lai's Taiji

In this paper, based on comparison and analysis between basic properties of the golden equiangular spiral and characteristics and distribution of various structural elements of the Hetu and Lai's Taiji, the matching schema of the Hetu and Lai's Taiji existed in ancient literature is improved and based on mining and analysing about the connotation in mathematics and Chinese medicine, a complete new interpretation is given, which reveals the close association among number distribution of the Hetu, basic geometric structures of the Lai's Taiji and the golden spiral. This paper provides an important inspiration on the origin and structure of the Taiji and Hetu researches. It is also of great significance and reference value for relationship research between the Hetu and Lai's Taiji as well as for the spiral-related exploration in Chinese medicine clinical practice. The Wuyin related laws implied in the improved schema presented in this article can provide inspiration for researches on TCM mechanism of human hearing and basic theory exploration of music therapy.

TCM Zheng Classification and Clinical Trials 2014.

TCM Zheng Classification and Clinical Trials 2014.

Enhanced evidence-based chinese medicine clinical practice guidelines in Hong Kong: a study protocol for three common diseases.

We presented a study protocol of developing Chinese medicine clinical practice guidelines for three common diseases in Hong Kong, including insomnia, chronic gastritis, and cerebral infarction. This research project will be conducted in three phases. First phase is the preparation stage which consists of the establishment of steering committee and panel. Second phase involves 6 steps, which are searching and identifying evidence, text mining process, Delphi survey, synthesizing of data, consensus conference, and drafting guidelines. In this phase, text mining technique, evidence-based method, and formal consensus method are combined to get consolidated supporting data as the source of CM CPGs. The final phase comprised external reviews, dissemination, and updating. The outputs from this project will provide three CM CPGs for insomnia, chronic gastritis, and cerebral infarction for Hong Kong local use.

Antipyretic and anti-asthmatic activities of traditional Chinese herb-pairs, Ephedra and Gypsum.

Mahuang-Shigao herb-pair is a famous formula composed of Ephedra and Gypsum. The herb-pair is frequently used for treating cold symptoms and bronchial asthma in the clinical practice of Chinese medicine (CM). In the present study, we evaluated evidence for the benefit of combined use of Ephedra and Gypsum by analyzing the antipyretic and anti-asthmatic activities of Ephedra-Gypsum. The antipyretic effects of Ephedra-Gypsum were evaluated in yeast-induced hyperthermia test. Thirty male Wistar rats were randomly divided into 5 groups, including control group, standard aspirin group, and 3 Ephedra- Gypsum groups of different doses (6, 12, 24 g/kg). Ephedra-Gypsum extract and asprin were administered orally 6 h after the injection of yeast solution and body temperature was measured every 1 h for 8 h. The antiasthmatic effects of Ephedra-Gypsum were evaluated using an ovalbumin (OVA)-induced asthmatic rat model. Thirty-six male SD rats were randomly divided into 6 groups. Rats were alternately sensitized and OVA+Al(OH) challenged by exposure to mists of ovalbumin. Ephedra-Gypsum extracts (6, 12, 24 g/kg) or dexamethasone were administered 45 min prior to the allergen challenge for 8 days. Latent period and the weight of wet to dry ratio of lung were determined. In addition, the eosinophils in blood and white blood cell (WBC) were counted by an YZ-Hemavet Analyzer. The Ephedra-Gypsum extracts at test dose (6, 12, 24 g/kg) significantly and dose-dependently attenuated yeast-induced fever in rats. The Ephedra-Gypsum extracts also prolonged the latent period, reduced OVA-induced increases in eosinophils and WBC, and decreased the wet and dry weight ratio of the lungs in the anti-asthmatic test. These findings indicate that the Ephedra-Gypsum extract has antipyretic and anti-asthmatic properties. Hence, the results support additional scientific evidence in prescriptions.

Study of ZHENG differentiation in hepatitis B-caused cirrhosis: a transcriptional profiling analysis.

BackgroundIn traditional Chinese medicine (TCM) clinical practice, ZHENG (also known as TCM syndrome) helps to understand the human homeostasis and guide individualized treatment. However, the scientific basis of ZHENG remains unclear due to limitations of current reductionist approaches.MethodsWe collected the leukocyte samples of three hepatitis B-caused cirrhosis (HBC) patients with dampness-heat accumulation syndrome (DHAS) and three HBC patients with liver depression and spleen deficiency syndrome (LDSDS) for microarray analysis. We generated Gene-Regulatory-Networks (GeneRelNet) from the differentially expressed genes (DEGs) of microarray date. Core genes were validated using anther independent cohort of 40 HBC patients (20 DHAS, 20 LDSDS) with RT-PCR.ResultsThere were 2457 mapped genes were differentially expressed between DHAS and LDSDS (Fold change ≥ 2.0, P < 0.05). There were markedly different genes co-expression patterns in DHAS and LDSDS. Furthermore, three differential co-expression genes including purine nucleoside phosphorylase (PNP); aquaporin 7 (AQP7) and proteasome 26S subunit, non-ATPase 2 (PSMD2) were screened by GeneRelNets, and their mRNA expressions were further validated by real time RT-PCR. The results were consistent with microarray. The PNP (P = 0.007), AQP7 (P = 0.038) and PSMD2 (P = 0.009) mRNA expression is significant difference between DHAS and LDSDS using the non-parametric test. Furthermore, we constructed an mRNA panel of PNP, AQP7 and PSMD2 (PAP panel) by logistic regression model, and evaluated the PAP panel to distinguish DHAS from LDSDS by area under the receiver operating characteristic curve (AUC) analysis, which showed a higher accuracy (AUC = 0.835). Gene ontology (GO) analysis indicated that the DHAS is most likely related to system process while the functions overrepresented by LDSDS most related to the response to stimulus.ConclusionsThis study suggested that there are particular transcriptional profiles, genes co-expressions patterns and functional properties of DHAS and LDSDS, and PNP, AQP7, and PSMD2 may be involved in ZHENG differentiation of DHAS and LDSDS in HBC.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6882-14-371) contains supplementary material, which is available to authorized users.

Promoting integrative medicine by computerization of traditional Chinese medicine for scientific research and clinical practice: The SuiteTCM Project

BackgroundChinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine (TCM) is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy. MethodsWe proposed the development of the SuiteTCM software, a collection of integrated computational models mainly derived from epidemiology and statistical sciences for computerization of Chinese medicine scientific research and clinical practice in all levels of prevention. The software includes components for data management (DataTCM), simulation of cases (SimTCM), analyses and validation of datasets (SciTCM), clinical examination and pattern differentiation (DiagTCM, TongueTCM, and PulseTCM), intervention selection (AcuTCM, HerbsTCM, and DietTCM), management of medical records (ProntTCM), epidemiologic investigation of sampled data (ResearchTCM), and medical education, training, and assessment (StudentTCM). DiscussionThe SuiteTCM project is expected to contribute to the ongoing development of integrative medicine and the applicability of TCM in worldwide scientific research and health care. The SuiteTCM 1.0 runs on Windows XP or later and is freely available for download as an executable application.

A comparative study on the hepatoprotective action of bear bile and coptidis rhizoma aqueous extract on experimental liver fibrosis in rats

Aim of the studyBear bile and Coptidis Rhizoma have been used in Chinese medicine with a long tradition in treating heat-diseases. Both bear bile and Coptidis Rhizoma are used to treat liver diseases in clinical practice of Chinese Medicine. Since bears are currently endangered, it raises the question whether the use of bear bile is ethical. To look for substitute for bear bile, the aim of this study is to compare the anti-fibrotic effects of Coptidis Rhizoma and its major component berberine with the actions of bear bile and its major compound tauroursodeoxycholic acid on experimental liver fibrosis in rats.MethodQuality assessment was conducted with high performance liquid chromatography. The experimental liver fibrosis in rats was induced by carbon tetrachloride, alcohol, and bile duct ligation respectively. The biochemical criteria in the blood and tissue samples were measured to evaluate the anti-fibrotic properties and underlying mechanisms of the drugs.ResultsCoptidis Rhizoma Aqueous Extract (CRAE), berberine, and bear bile exerted anti-fibrotic properties on various liver fibrosis models in rats. CRAE and berberine significantly reduced the peroxidative stress in liver through increasing the superoxide dismutase enzyme activity. CRAE and berberine were able to excrete bilirubin products from the liver and protect hepatocytes from cholestatic damage. The effect of CRAE and berberine are comparable to that of bear bile.ConclusionInstead of using bear bile, CRAE and berberine can be potential substitutes in treating liver fibrosis.

Understanding the viscera-related theory that the lung and large intestine are exterior-interiorly related

Pairing of the viscera and bowels is an important theory, which provides guidance to traditional Chinese medicine (TCM) clinical practice. Investigating this theory has been the focus of research on the basic theory of TCM. Recently, researchers have performed many studies on the theory that the lung and large intestine are exterior-interiorly related, which is a different point of view to that of previous literature, recent clinical studies and experimental studies, and these recent studies have enforced the theoretical connotation of the statement. However, there are problems in some of these studies including recent clinical studies and experimental studies. In the current article, literature on the viscera-related theory of the lung and large intestine are exterior-interiorly related is reviewed from physiological, pathological, and clinical views, and some opinions on the current research status are discussed.

Issues on translation of terms in traditional Chinese medicine clinical practice

Issues on translation of terms in traditional Chinese medicine clinical practice

Oral herbal medicines for psoriasis: A review of clinical studies

Various forms of complementary and alternative medicine are used in psoriasis. Among these, herbal medicines are frequently used as systemic and/or topical interventions either as a replacement for or in conjunction with conventional methods. The benefit of such use is unclear. This review is to provide an up-to-date review and discussion of the clinical evidence for the main kinds of herbal therapies for psoriasis. Searches of the biomedical databases PubMed (including MEDLINE), EMBASE and CINAHL were conducted in December 2011 which identified 32 clinical studies, all published in English. Twenty of these primarily tested topical herbal medicines and were thus excluded. The 12 studies that evaluated systemic use of herbal medicines were included in the review. Four were case series studies and the other 8 were controlled trials. In terms of interventions, 4 studies tested the systemic use of plant oils combined with marine oils and 8 studies tested multi-ingredient herbal formulations. The clinical evidence for plant and animal derived fatty acids is inconclusive and any benefit appears to be small. For the multi-herb formulations, benefits of oral herbal medicines were shown in several studies, however, a number of these studies are not controlled trials, a diversity of interventions are tested and there are methodological issues in the controlled studies. In conclusion, there is promising evidence in a number of the studies of multi-herb formulations. However, well-designed, adequately powered studies with proper control interventions are needed to further determine the benefits of these formulations. In addition, syndrome differentiation should be incorporated into trial design to ensure effective translation of findings from these studies into Chinese medicine clinical practice.

Clinical Distribution and Molecular Basis of Traditional Chinese MedicineZHENGin Cancer

In traditional Chinese medicine (TCM) clinical practice, ZHENG (also known as syndrome) helps to guide design of individualized treatment strategies. In this study, we investigated the clinical use of ZHENG in TCM-treated cancer patients by systematically analyzing data from all relevant reports in the Chinese-language scientific literature. We aimed to determine the clinical ZHENG distributions in six common cancers (lung, liver, gastric, breast, colorectal, and pancreatic) with the expectation of uncovering a theoretical basis for TCM ZHENG as a clinical cancer treatment. In addition, we also reviewed the molecular basis underlying Xue-Yu (blood stasis), Shi-Re (dampness-heat), Yin-Xu (Yin deficiency), and Pi-Xu (spleen deficiency) ZHENG that are commonly found in cancer patients. The results from our summary study provide insights into the potential utility of TCM ZHENG and may contribute to a better understanding of the molecular basis of TCM ZHENG in cancer.

Exploring the Same Syndrome Existing in RA and DM through Data Mining

Abstract It is meaningful to search for the same syndromes existing among different diseases. One important terminology in Chinese medicine is called treating different diseases with the same therapy. In the clinical practice of Chinese medicine, some patients with rheumatoid arthritis and some other patients with diabetes mellitus can be treated with similar therapies. This suggests that there should be something commonly existing in the literature of different diseases unrevealed, i.e., biological networks. It is possible to mine those similar biological networks out. In this paper, we propose an algorithm to retrieve simple and meaningful networks from large data sets of rheumatoid arthritis and diabetes mellitus. We transfer XML type data sets to the structured database of Microsoft® SQL® and visualize them into different graphs by software Cytoscape. The results suggest that Huangqi (Radix Astragali), Guizhi (Ramulus Cinnamomi), Shaoyao (Radix Paeonise Alba), Zhimu (Rhizoma Anemarrhenae), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Maidong (Tuber Ophiopogonis), Shaoyao (Radix Dioscoreae), and Xuanshen (Radix Scrophulariae) are the commonly used herbal medicines. Huangqi (Radix Astragali) and Danggui (Radix Angelicae Sinensis) are of the core association. Quickening the blood and transforming stasis is the treatment principles for some pattern of rheumatoid arthritis and diabetes mellitus. The network visualized in these figures shows that those pairs of herbs in the two diseases are associated with the central commonly-existing biological networks.

Biological Basis of Cold and Heat Pattern of Rheumatoid Arthritis in Traditional Chinese Medicine

Abstract An integrative mode of the disease classification in Western medicine and the syndrome differentiation in Chinese medicine is already the chief mode of sorting applied in clinical practice of Chinese medicine and integrative medicine. In this study, the cold and heat pattern of rheumatoid arthritis were comparatively analyzed. A range of facts, including the correlation of syndrome differentiations and therapeutic effects, the difference of laboratorial examination and omics expression between cold and heat pattern of RA were reviewed to demonstrate the biological basis of RA syndrome differentiations. It indicates that the better knowledge of the biological basis involved in syndrome differentiations of Chinese medicine might help to choose the most appropriate treatment.

Guidelines for evidence-based Chinese medicine clinical pathway report

Clinical pathway (CP), as a standardized approach and clinical management process for disease diagnosing and treating, is being widely used with more relevant publications reported gradually. But different forms of CP reports may prevent the evaluation and spreading of CP. The authors recommend guidelines for evidence-based Chinese medicine CP report, including 18 items which form 5 big sections, by precise item selection and rigorous expert consensus. All these items can embody the principles of Chinese medicine and comply with the requirements of the clinical practice of Chinese medicine. All above are based on synthesizing the published literature systematically and analyzing the current status in this field, also according to the characteristics of Chinese medicine and methodology requirement of evidence-based medicine.

Study designs of randomized controlled trials not based on Chinese medicine theory are improper

Current biomedical research methods to evaluate the efficacy of Chinese medicine interventions are often conceptually incompatible with the theory and clinical practice of Chinese medicine. In this commentary, we (1) highlight the theory and principles underlying Chinese medicine clinical practice; (2) use ginseng as an example to describe clinical indications in Chinese medicine; (3) propose a framework guided by Chinese medicine theory for the evaluation of study designs in Chinese medicine research; and (4) evaluate 19 randomized, double-blind, placebo-controlled trials of ginseng. Our analysis indicates that all 19 trials with both positive and negative results confirm the specific effects of ginseng indicated by Chinese medicine theory. Study designs guided by Chinese medicine theory are necessary to validate and improve future randomized controlled clinical trials in Chinese medicine.