TCM Medicine Research Articles

From clinical appearance to accurate management in acute ischemic stroke patients: With the guidance of innovative traditional Chinese medicine diagnosis.

ObjectiveTo investigate the correlation between simplified classification and laboratory indicators in patients with acute ischemic stroke, also provide accurate evidences for simplified classification and guide clinical interventions and treatment.MethodsTwo hundred patients with acute ischemic stroke were classified into four types according to the characteristics of Traditional Chinese Medicine syndrome: phlegm‐heat syndrome, phlegm‐dampness syndrome, qi deficiency syndrome, and yin deficiency syndrome. The differences between the types of syndromes and the correlation between laboratory indicators and syndromes were analyzed.ResultsAmong the 200 patients with acute ischemic stroke, there were significant differences in the level of low‐density lipoprotein (LDL‐C) (p < .05) between patients with phlegm‐heat syndrome and other three types. There were significant differences in the levels of homocysteine (HCY) and fibrinogen (Fib) between patients with yin deficiency syndrome and other three types (p < .05). In addition, there were statistically significant differences in blood glucose (Glu), glycosylated hemoglobin (HBA1c), and total cholesterol (CHO) between phlegm‐heat syndrome and qi deficiency syndrome (p < .05). There were significant differences in the levels of Glu, HBA1c, D‐2 polymer (D‐D), and C‐reactive protein (CRP)s between patients with phlegm‐heat syndrome and phlegm‐dampness syndrome (p < .05). There were statistically significant differences in the levels of CRP and urea nitrogen between patients with yin deficiency syndrome and phlegm‐dampness syndrome and qi deficiency syndrome (p < .05).ConclusionsThe four‐type simplified classification of Integrated TCM and Western medicine in acute ischemic stroke has specific laboratory data to support. Simplified classification with TCM treatment and intervention of different patients improves the survival and treatment, which is an innovative, easy‐to‐master clinical diagnosis and treatment model.

Delivery of patient-centered care in complementary medicine: Insights and evidence from the Chinese medical practitioners and patients in primary care consultations in Hong Kong

IntroductionTraditional Chinese Medicine (TCM) has become increasingly popular around the world, and has been accepted by people not only in China and Southeast Asia, but also in Western countries. Despite its historic role in the Chinese society, there has been limited research on exploring the nature of TCM practitioner-patient interactions in the Chinese context. As indicated by a major study regarding the Hong Kong context1, there is a need to investigate the role of TCM practitioner and promote interdisciplinary research to ensure safety and synergy of TCM and Western medicine in primary care. This study aims to address this gap by investigating the nature of TCM consultations and their communication patterns in Hong Kong. MethodsBased on 10 h of conversations (in Cantonese) between TCM practitioners and their patients in the diagnostic interviews, the study explored how the doctor-patient relationship was negotiated in the course of the consultation, while both the TCM practitioners and the patients were constantly trying to manage and maintain common ground. Particular attention had been paid to the identification of specific linguistic and discourse strategies that TCM practitioners had employed to establish doctor-patient rapport, so that a better understanding of patient-centred care in the TCM context could be obtained. The participants were recruited from a local university operated clinic which shared the characteristic of TCM practitioners in Hong Kong. ResultsA range of linguistic strategies that TCM practitioners used to deliver patient-centred care have been identified. These strategies are also helpful in shaping a joint decision-making process that will lead to better patient understanding and compliance with the doctors’ treatments. ConclusionsThis study demonstrates empirically how TCM practitioners utilize a range of linguistic resources and communication strategies to shape the ongoing discourse so that their patients can have a better understanding of their illnesses. For an example, it is found that TCM practitioners and their patients were constantly trying to manage and maintain common ground by using a range of grammatical markers, including sentence-final particles (SFPs) and discourse markers (DMs), to negotiate the epistemic commitment so that the patient would have good compliance with the practitioner’s suggested treatment. It is also observed that various types of interrogatives have been used by the TCM practitioners to elicit information from the patients as well as to encourage them to talk and make a response. Furthermore, it is found that TCM practitioners would deliberately enquire about the patients’ everyday experiences because what they eat, do, and encounter all have an important impact on their body conditions. By exploring into the patients’ daily routines in the social talk, the practitioner can help maintain and promote the overall balance of the patient’s body, and help them monitor and enhance their health conditions by modifying their daily habits and behaviours. With the adoption of these linguistic and communication strategies, the TCM practitioners are shown to have placed the patients’ needs as their top priority. Previous studies in the field have already proved that co-construction of the treatment plan between the doctor and the patient is extremely important, and that a patient-centred approach can largely reduce adverse events leading to avoidable patient harm. The specific strategies identified in the current study can enhance the TCM practitioners’ communication with patients, creating an environment that will surely optimise safety for both patients and clinicians.

Implementing the medical and health care model of the integrated traditional Chinese medicine & western medicine in medical education of UCLA

Based on the holism, the medical and health care model of the Integrated Traditional Chinese Medicine & Western Medicine is referred that the practitioners who work with the TCM & Western medicine, apply the methods combined western medicine with TCM to treat patients and health educationfrom the person-centric holism. Professor Ka-Kit Hui, who is the founder of the East and West Medical Center (CEWM) belonged to the University of California, Los Angeles vigorously advocate, and always adhere to the education and clinical. In this paper, we briefly introduced this model. Taking clinical case discussion of CEWM as an example, we focused on and summarized how the team of CEWM applied this model to train the clinical practitioners who would like to work in the Integrated Traditional Chinese Medicine & Western Medicine. Through this paper, we hope we could get some useful references for the education of Chinese integrated traditional Chinese medicine & western medicine practitioners. Key words: Education, traditional Chinese medicine and pharmacy; Holism; Integrated traditional Chinese medicine & western medicine; Medical and health care model; Medical records

TREATMENT OF PATIENTS WITH ADVANCED CANCER FOLLOWING CHEMOTHERAPY AND TRADITIONAL MEDICINE - LONG TERM FOLLOW UP OF 75 CASES

Objective: Traditional systems of medicine all over the world even traditional medicine and cancer have been using plants and plants products for therapeutic intention. The purpose of these retrospective trials is to assess the clinical efficacy of chemotherapy in conjunction with TCM for a broad variety of cancers. Methods: 75 patients with available cancers were concluded in the study during September1993 – May 2018.The sex ratio of male: female was 50:25 respectively. The mean age at onset was 46.9 years（range 10-79 years. All patients were treated with different dosage of various chemotherapy in combination with TCM or traditional medicine alone. The basic chemotherapeutic regimen consisted of vincristine（VCR, 1-2 mg/week)、cyclophosphamide（CTX, 200-1, 000mg/ week), mitomycin C(MMC, 2-4mg/week) and 5-fluorouracil（5-Fu,250-500mg/ day). The detail prescription of TCM varied among a broad variety of carcinomas. The criteria of complete remission（CR）and/or partial remission（PR）is according to the rules where physicians have in common with in clinics. In 75 cases, the CR was obtained in 33(44%) advanced cancers, a short CR in 11(14.7%) cases, PR in 25 (33.3%) cancers, stable disease in 6 cases.. The crude herbs consisted of sargassum, tangle, Oyster（mussels), Poria cocos, Ophiopogon japonicus, Prunella vulgaris, Taraxacum, Scrophularia ningpoensis, Cremastra appendiculata, Trichosanthes Kirilowii, Sophora subprostrata, Houttuynia cordata, Scutellaria barbata d. don and Oldenlandia diffusa roxb. Results: Among those long-term survivors, 31 carcinomas obtained in disease-free survival over 5 years, 20 cancers were survival over 10 years, the longest four patients over 25 years. Conclusion: In this study, it was experienced that a CR was a pivotal influencing factor in those longest survival patients, and traditional medicine was also recommended. Down regulating oncogenic receptors may be useful paradigm and perspective in currently the third line setting of clinical target therapy and in rendering our better understanding of cancer biology. Peer Review History: Received 5 June 2018; Revised 4 July; Accepted 8 July, Available online 15 July 2018 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dr. Nuray Ari, Ankara University, Turkiye, ari@ankara.edu.tr Dr. Mohamed Salama, Modern University for Technology & Information, Egypt, salama47@yahoo.com Similar Articles: ESTIMATION OF ANTI-INFLAMMATORY ACTIVITY AS WELL AS APOPTOTIC ACTIVITY OF ETHANOLIC EXTRACTS OF CROCUS SATIVUS

Understanding of the trigger points of myalgia: acupuncture and dry needling exploration and modern acupuncture mechanism

The similarities and differences between trigger points of myalgia and acupoints were explored. Nodules could be detected by B-ultrasound at trigger points of myalgia, but not acupoints. In clinical symptoms, the referred pain pathway of trigger points of myalgia is similar with the pathway of acupuncture meridian. Therefore, the location of trigger points of myalgia should take referred pain as pathway, which is similar with locating acupoints as meridian. Acupuncture at trigger points of myalgia takes jumping feeling as criterion, while acupuncture at acupoints are mainly based on acid swelling and numbness. From clinical observation to basic experimental research, a lot of pathophysiological evidence is provided for trigger point of myalgia. It is believed that the trigger point of myalgia might be the precise acupoint in modern scientific research, and the meridian is the synthesis of the mechanics of nerve, blood vessel and fascia. Although acupuncture and dry needling are different in theory, but the scientific foundation of TCM and western medicine is coherent.

Study on the stability control strategy of Triphala solution based on the balance of physical stability and chemical stabilities

Triphala is a well-known prescription in Indian Ayurveda and TCM medicine for its great effect on gingivitis and hyperlipidemia. However, its solution is unstable for the containing of excessive polyphenol, leading to the production of sediment in the short term and the decrease of efficacy. Based on the analysis of sediment formation, a novel control strategy is proposed. To conduct the analysis, the sediment formation was recorded for a consecutive five days. The changes in the composition of the supernatant and the sediment were studied by the HPLC profile analysis. The main components of the sediment were identified as corilagin, ellagic acid and gallic acid, and the amount of ellagic acid sediment increased with the storage time. Then, with a series of pH status adjustments of the Triphala solution, the physical and chemical stabilities were acquired by Turbiscan and HPLC respectively. The results showed that as the pH value increased, so did the physical stability, but the particle size and TSI of the association decreased. While the fingerprint of chemical profile similarity decreased, so did the chemical stability. Combining physical and chemical stability parameters, an equilibrium point was found out. When the pH value was adjusted to 5.0, both the physical and chemical stabilities were better: the verification test showed that the sedimentation inhibition rates on the 3rd, 5th,10th and15th days were 41%, 55%, 41%, and 23%, respectively. This manuscript provided a new control strategy that will pique pharmaceutical and food development engineers’ interest and trigger research ideas controlling the quality of decoction.

Research progress of fire needling for chronic gastritis

To explore the efficacy and mechanism of fire needling for chronic gastritis, "fire needling" and "chronic gastritis" were selected as keywords to collect literature in PubMed, CNKI database and WanFang database. The clinical and experiment literature regarding fire needling for chronic gastritis was analyzed to make a comprehensive discussion on the efficacy and action mechanism of fire needling for chronic gastritis. The results indicated the efficacy of fire needling for chronic gastritis was superior to that of medication or filiform needle. The combination of fire needling and medication, acupoint injection and filiform needle could further improve the therapeutic effect for chronic gastritis. From the perspectives of TCM and western medicine, the action mechanism of fire needling for chronic gastritis was explored, and it was believed the fire-needle therapy has the effects of removing and nourishing, which conformed to the clinical syndromes of chronic gastritis. The fire needle could affect the prognosis by regulating the central nerve system, improving local blood circulation, regulating immune inflammation and regulating gastrointestinal hormones.

Effect of Aidi Injection plus TACE on Hepatocellular Carcinoma: A Meta-Analysis of Randomized Controlled Trials.

We aim to conduct a meta-analysis of studies on the effect of Aidi injection combined with TACE in the treatment of hepatocellular carcinoma (HCC). China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), Allied and Complementary Medicine Database (AMED), EMBASE, Web of Science, PubMed, and Cochrane Library databases to October 1, 2017, were searched to collect the studies. The data analysis was performed using RevMan 5.3 software. Totally 20 clinical trials with 774 (the experimental group: 447 cases; the control group: 327 cases) HCC patients were finally included in this meta-analysis. Meta-analysis results showed that Aidi injection combined with TACE can, to some extent, enhance the clinical effect and improve the overall survival. Meanwhile, it can increase HCC patients' quality of life. Additionally, Aidi injection plus TACE can reduce adverse events including leukopenia, gastrointestinal reaction, and liver damage in HCC patients (all P < 0.05). Therefore, Aidi injection plus TACE may significantly enhance the clinical effect, suggesting that the combination of TCM and western medicine is promising. The exact outcome needs rigorously designed performances, multicenter, and large randomized controlled trials.

Study of the similarities and differences between TCM and Tujia medicine in clinical diagnosis and treatment of liver cancer

Study of the similarities and differences between TCM and Tujia medicine in clinical diagnosis and treatment of liver cancer

Brief discussion on acupuncture technique "controlling Qihai to regulate blood pressure" proposed by academician SHI Xuemin

According to Qihai theory, academician SHI Xuemin established the acupuncture technique "controlling Qihai to regulate blood pressure" which focused on Renying (ST 9), and achieved favorable effects in clinical application. In this paper, based on the Qihai theory, from aspects of Yuanqi, Zongqi, Yingqi and Weiqi and relations among qi, blood and veins in TCM, and cardiac output, sympathetic nerve activity and blood vessels in modern medicine, the understanding on hypertension was explained. As a result, both TCM and modern medicine had consistency in the understanding of hypertension, reflecting the scientificity and practicability of this acupuncture technique. Besides, according to Qihai theory and "wind leading to vertigo" theory, academician SHI Xuemin brought forward the key pathogenesis of hypertension was "dysfunction of Qihai", and the acupoint selected Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). At the same time, the operation specification of each acupoint was mainly discussed, and the references of acupoint selection was explained based on TCM theory and modern clinical research.

Characteristics and principles of acupoint selection in auricular plaster therapy for hypertension based on literature analysis

The characteristics and principles of acupoint selection in auricular plaster therapy for hypertension were explored. By searching CNKI (search time from 1950 to November of 2015), VIP database (search time from 1989 to November of 2015) and WanFang Database (search time from 1983 to November of 2015), the clinical research literature regarding auricular plaster therapy for hypertension was collected, and frequency statistics method was used for analysis. As a result, totally 117 articles were included. The auricular points with frequency from high to low were Jiangyagou, Shenmen (TF4), Gan (CO12), Xin (CO15), Shen (CO10), Jiaogan (AH6a), Pizhixia (AT4), Jiangyadian and Neifenmi. The TCM syndromes with frequency from high to low were excessive accumulation of phlegm-dampness syndrome, upper hyperactivity of liver yang syndrome, yin deficiency and yang hyperactivity syndrome and excessive liver-fire syndrome. In conclusion, based on cross-reference of TCM and modern medicine combination of zangfu and meridians differentiation and valuing the auricular points from clinical experience, the auricular plaster therapy for hypertension was characterized with "treating the principal and subordinate symptoms simultaneously and respectively" and "differentiation-based selection of auricular points to regulate zangfu", which could fully take the anti-hypertension advantages of non-pharmacotherapy.

Clinical efficacy of Jiawei Dihuang decoction combined with valsartan in treatment of early diabetic nephropathy

One hundred patients with early diabetic nephropathy were randomly divided into control group and study group with 50 cases in each group. All patients received conventional antidiabetic therapy with valsartan tablets 80mg, q. d; patients in study group were given additional TCM Jiawen Dihuang decoction. TCM syndrome scores, relevant biochemical testing and renal function changes were evaluated before and after treatment in two groups. After 8 weeks of treatment, the results showed than the TCM scores in both groups were significantly reduced (study group: 18.9±1.6 vs. 7.2±5.1, control group 18.8±1.5 vs. 10.3±6.2. both P<0.05); the improvement rate of TCM syndrome in study group was significantly higher than that of control group (90% vs. 68%, χ2=5.3, P<0.05) ; and the improvement of relevant biochemical index and renal function in study group was more marked than that in control group. The study indicates that the integrated TCM and Western medicine can enhance the efficacy in treatment of early diabetic hephropathy. Key words: Early diabetic nephropathy; Valsartan Tablets; insulin; TCM therapy; clinical effect

Choices between Chinese and Western medicine in Hong Kong – interactions of institutional environment, health beliefs and treatment outcomes

BackgroundAbout 15–20% of the general public in Hong Kong consult TCM practitioners. This study explored the decision making process involved in Hong Kong Chinese's choice between TCM and western medicine. MethodsEight focus group interviews (six to eight participants per group) and four individual interviews were conducted. ResultsThe participants kept an “old fashioned” concept of TCM. Many saw TCM as a non-scientific practice and had stronger trust on the credibility of western medicine. Some participants, however, preferred the more personalized treatment approach of TCM. While western medicine was usually the initial choice, the participants were pragmatic to adopt TCM when they felt western medicine was not working, or to supplement the treatment. They were often referred by members of their social networks. ConclusionThe public' perception of TCM lagged behind its actual development. Many TCM users are pragmatic users who learn through trial and error.

The indications of acupuncture-moxibustion in China state-compiled textbooks

The Acupuncture-moxibustion and Acupuncture-moxibustion therapy have been the state-compiled textbooks of acupuncture-moxibustion in colleges and universities of TCM for nearly more than half a century, which play a regulating and guiding role for acupuncture education and to a certain extent represent the development status of this discipline. The indications included in Acupuncture-moxibustion from 1th edition to 7th edition and Acupuncture-moxibustion therapy from 1th edition to 3rd edition were analyzed in this study, which was aimed to basically reflect the current situation of acupuncture indications. As a result, it was found the inheritance and innovation of indications were both reflected in each edition of textbooks, 1/3 of which occurred repeatedly in more than half of the textbooks, and 1/3 of which occurred only once. The indications were classified by internal medicine, surgery, gynecology, dermatology, orthopedics, etc., which were not consistent with system classification of modern medicine such as digestive system, respiratory system, etc. The indications were mainly named after TCM disease names, involving only several names of western medicine diseases, which were contradicted to the names adopted from journals and literature. This inconformity of classification method and naming method between TCM and western medicine was not only a difficulty for modern acupuncture and moxibustion, but also an essential factor to hinder the development of acupuncture, therefore comparative study was needed in the future.

Discussion of acupuncture for diabetic peripheral neuropathy based on blood stasis theory

Based on the understanding of TCM and western medicine on diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN), the relationship between DPN pathogenesis and blood stasis of TCM is discussed from the perspective of modern medicine. It is indicated blood stasis is the key pathogenesis to DPN, and a two-step acupuncture treatment of DPN from the theory of blood stasis is proposed. The first step is to analyze the pathogenesis of blood stasis, which could block the progress of the disease and diminish the symptoms. The second step is to apply acupuncture for pathological result of blood stasis by following the principle of eliminating exogenous pathogen, as a result, the purpose of treating both symptoms and root cause is achieved.

녹내장의 신경 보호 치료에 대한 동서의학적 고찰

Objectives : The aim of this study is to understand neuroprotection therapy of glaucoma with both Korean and western medicine.Methods : We searched Pubmed on the title "glaucoma" and "neuroprotection" and also searched CNKI(China National Knowledge Infrastructure) and OASIS(Oriental Medicine Advanced Searching Integrated System) on the title "glaucoma".Results : The results are as follows. 1. In western medicine, excitotoxicity inhibition, immunomodulation, oxidative stress suppression, supplement of NTFs and stem cell therapy are studied with neuroprotection therapy of glaucoma. 2. Treatment of glaucoma in TCM and Korean medicine are associated with liver(肝) and kidney(腎).Conclusions : Korean medical approaches on neuroprotection therapy of glaucoma can be significant, and further studies are needed to research.

Propuesta de análisis sinomédico de la célula

Integrative medicine must try to find identify areas of common ground to promote mutual understanding of the interacting health systems. Explaining cells using TCM methodology is an example of a possible harmonious interaction between TCM and Modern Medicine. Locating the cell based on evolutionary stages of pathogenic energies is a proposal that we have long outlined and it shows a better theoretical basis. The global proposal is to build a relationship of elements in this way: Taiyang-extracellular matrix; Shaoyang-plasma membrane; Yangming-cytosol; Taiyin-cytoplasmic organelles; Jueyin-intracellular communication; and Shaoyin-nucleus. Consequently, aside from being able to explain and understand multiple physiological, pathophysiological, infectious and pharmacological processes, point selection, herbal medicines and TCM formulas can be explained so assist with problems related to cell regions or cellular or subcellular functions.

When the East meets the West: the future of traditional Chinese medicine in the 21st century

Abstract Traditional Chinese medicine (TCM) has been practiced in China for thousands of years. In the past decade, there have been intensive debates in China about the nature of this ancient practice and its future development. Some critics argue that TCM theories are inaccurate descriptions of the human body that verge on imagination, and so have no place in modern healthcare systems. Other, however, say that TCM has a lot to offer to Western science and medicine and that emerging analytical tools hold great potentials in bridging the gap between the two worlds with contrasting philosophy and approaches. In a forum chaired by National Science Review's Executive Associate Editor Mu-ming Poo, five panelists from diverse backgrounds discussed the differences between TCM and Western science and medicine, recent progress in TCM research, and key challenges in modernizing this ancient practice. Hongxin Cao Director of Science and Technology Bureau, State Administration of Traditional Chinese Medicine of the People's Republic of China Aiping Lu Dean of the School of Chinese Medicine at Hong Kong Baptist University Yiling Wu President of Hebei Academy of Integrative Chinese and Western Medicine Boli Zhang President of Tianjin University of Traditional Chinese Medicine and President of the Chinese Academy of Traditional Chinese Medicine Liping Zhao Professor and former deputy director of the Shanghai Center for System Biology at Shanghai Jiao Tong University Mu-ming Poo (Chair) Neuroscientist and Director of Chinese Academy of Sciences’ Institute of Neurosciences in Shanghai

中国新医药学的应激理论和系统调节

新世纪里生命科学的飞跃发展，使原以神经科学为主流的时代进步到了应激科学时代。其中中医药现代化的研究成果起到了推波助澜的作用，例如《袁氏新医药模式与临床》在2013年的出版就说明了此点。其中独树一帜的应激系统和系统性调节理论，不仅弥补了现代生理病理学之不足，而且对“现代神经–体液调节理论”、“现代人体平衡调节系统”和“生命力本质”等瓶颈问题有了破解。这也对阐明中西医学的科学本质，以及创建既高于中医又高于西医的中国新医药学模式，提供了坚实的科学基础。特别是具有先进理论和独到临床的第三医学模式的展示，可以说是世界两大主流医学有机结合的突破，关乎世界大同医学的终极前景，因此值得学术界的关注。 It is an era in which life science is developing rapidly in the new century. The original mainstream of neuroscience could be replaced by the theory of irritability. The new research results of modernized TCM promote this process just as the author pointed out in his book Yuan’s New Medical Mode and Clinical Practice in 2013. In particular, the theory of irritability and systemic regulation not only remedied the previous defects of physiology and pathology but also resolved some difficulties in the “Bottleneck” such as “Modern Neural-humoral Regulation Theory”, “Modern Human Body Balance Adjustment System” and “The Quintessence of Life Force” etc. Yet, these could clarify the mode of New Chinese Medicine which would be better than either TCM or Western Medicine. Such third mode of medicine with advanced theory and clinical practice could make giant strides in the sector of integration of TCM and Western Medicine; this is worthy of academic attention.

Aspect of QOL Assessment and Proposed New Scale for Evaluation

Aspect of QOL Assessment and Proposed New Scale for Evaluation