TCM Physicians Research Articles

Thinking style preferences of Chinese and Western physicians: A mixed-methods study

IntroductionTraditional Chinese medicine (TCM) and Western medicine (WM) stem from distinct cultural and regional contexts, with the primary difference in their approaches to clinical reasoning. This study aims to investigate the cognitive preferences of TCM and WM physicians in clinical diagnosis and treatment, providing valuable insights for the advancement of TCM. MethodsWe implemented a two-phase mixed methods approach comprising questionnaires and semi-structured interviews. The Thinking Style Inventory (TSI) was used to evaluate the thinking styles of physicians through convenience sampling. Additionally, a total of six physicians (three practicing TCM and three WM) were selected by purposive sampling and open-ended responses regarding self-cognition and influencing factors were analyzed using thematic analysis. ResultsA total of 150 surveys and six interviews consistently indicated a preference among both TCM and WM physicians for Legislative, Executive, Hierarchical, Liberal, and External styles. In contrast, TCM physicians exhibited a tendency towards Legislative and Liberal styles, whereas WM physicians leaned towards Executive and Judicial styles. Thematic analysis of the interviews revealed four themes: self-understanding, thinking characteristics, influencing factors, and style changes. ConclusionOur study identified that within TCM and WM, a blend of shared characteristics and distinct individuality in thinking styles existed, exhibiting variations in the growth processes of physicians. Both TCM and WM physicians attributed the formation of their thinking styles to factors such as education, internship experience, Chinese social culture and personal disposition. Furthermore, empirical research methods emerged as effective tools for studying clinical reasoning in healthcare contexts.

Review on melanosis coli and anthraquinone-containing traditional Chinese herbs that cause melanosis coli.

Backgrounds: The incidence of melanosis coli (MC) has gradually increased annually, attracting significant attention and efforts into this field. A potential risk for MC is the long-term use of anthraquinone laxatives in patients with constipation. Most traditional cathartic drugs are made from herbs containing anthraquinone compounds. This review aims to provide guidance for the application of traditional Chinese herbs containing anthraquinones for physicians and researchers. Materials and methods: We reviewed risk factors and pathogenesis of MC, and natural anthraquinones isolated from TCM herbs. We searched Pubmed and CNKI databases for literature related to MC with keywords such as"traditional Chinese medicine", "Chinese herbs", "anthraquinones", and "melanosis coli". The literature is current to January 2023 when the searches were last completed. After the literature retrieval, the TCM herbs containing anthraquinones (including component identification and anthraquinone content determination) applied in clinical were selected. According to the collected evidence, we provide a list of herbs containing anthraquinones that could cause MC. Results: We identified 20 herbs belonging to 7 families represented by Polygonaceae, Fabaceae, Rhamnaceae, and Rubiaceae, which may play a role in the pathogenesis of MC. Among these, the herbs most commonly used include Dahuang (Rhei Radix et Rhizome), Heshouwu (Radix Polygoni Multiflori), Huzhang (Rhizoma Polygoni Cuspidati), Juemingzi (Semen Cassiae), Luhui (Aloe) and Qiancao (Rubiae Radix et Rhizoma). Conclusion: Due to a lack of awareness of the chemical composition of TCM herbs, many patients with constipation and even some TCM physicians take cathartic herbal remedies containing abundant anthraquinones to relieve defecation disturbances, resulting in long-term dependence on these herbs, which is potentially associated with most cases of MC. When such treatments are prescribed, TCM physicians should avoid long-term use in large doses to reduce their harm on colonic health. Individuals who take healthcare products containing these herbs should also be under the supervision of a doctor.

Satisfaction of patients with diabetic kidney disease with traditional chinese medicine physician visits

BackgroundPatient-centred care is an important part of quality healthcare and patient satisfaction has been shown to be associated with improved clinical outcomes. We aim to explore the satisfaction of patients with diabetic kidney disease (DKD) with their visits to the TCM physician and its association with patients' socio-economic characteristics. MethodsA questionnaire survey was conducted among patients aged >21 years with DKD. Participants' demographic, socioeconomic characteristics and satisfaction scores measured with the self-administered Medical Interview Satisfaction Scale (MISS) were collected after they visited the TCM physician. MISS is a 26-item questionnaire consisting of three domains – cognitive, affective and behavioural which was developed to assess patient satisfaction with medical consultation. Independent samples t-test and one-way analysis of variance (ANOVA) were used to analyse the data. Results137 participants completed the questionnaires and were included in the analysis. The mean satisfaction score was 3.1 out of 5, with the cognitive domain being significantly higher compared to the affective and behavioural domains. The mean satisfaction score of the cognitive domain differed significantly among participants staying in different types of housing and those with previous TCM encounters. The mean satisfaction score of the behavioural domain differed significantly among participants of different ethnicities. The mean satisfaction scores of all the domains were also significantly different among participants with different duration of follow-up with their TCM physicians. ConclusionWe found that ethnicity, types of housing, previous TCM experience and the duration of follow-up with the TCM physician may affect the satisfaction scores of patients with DKD.

Research on Application Paradigm of Random Sampling Method in Data Analysis of Traditional Chinese Medicine—Taking Insomnia Prescriptions of Famous Old Tcm Physicians as an Example

Research on Application Paradigm of Random Sampling Method in Data Analysis of Traditional Chinese Medicine—Taking Insomnia Prescriptions of Famous Old Tcm Physicians as an Example

Chinese Herbal Medicine and Its Regulatory Effects on Tumor Related T Cells.

Traditional Chinese medicine is an accepted and integral part of clinical cancer management alongside Western medicine in China. However, historically TCM physicians were unaware of the chemical constituents of their formulations, and the specific biological targets in the body. Through HPLC, flow cytometry, and other processes, researchers now have a much clearer picture of how herbal medicine works in conjunction with the immune system in cancer therapy. Among them, the regulation of tumor-related T cells plays the most important role in modulating tumor immunity by traditional Chinese medicine. Encouraging results have been well-documented, including an increase in T cell production along with their associated cytokines, enhanced regulation of Tregs and important T cell ratios, the formation and function of Tregs in tumor microenvironments, and the promotion of the number and function of normal T Cells to reduce conventional cancer therapy side effects. Chinese herbal medicine represents a rich field of research from which to draw further inspiration for future studies. While promising agents have already been identified, the vast majority of Chinese herbal mechanisms remain undiscovered. In this review, we summarize the effects and mechanisms of specific Chinese herbs and herbal decoctions on tumor related T cells.

Study on medication regularity of chronic atrophic gastritis in Beijing-Tianjin-Hebei region based on latent structure model

To explore the etiology, pathogenesis, distribution of syndromes and the rule of medication of chronic atrophic gastritis(CAG) in Beijing-Tianjin-Hebei region based on the latent structure model. Chronic atrophic gastritis of 279 cases in Beijing-Tianjin-Hebei region were extracted from the established database of spleen and stomach diseases of famous veteran Chinese medicine experts. The latent structure models of symptoms and drugs of chronic atrophic gastritis were constructed by using Lantern 3.1.2 software, and the latent structure models were interpreted. SAS 10.0 software was used to mine association rules of drugs and symptoms. The constitutional characteristics of patients with chronic atrophic gastritis in Beijing-Tianjin-Hebei region were "turbid toxin and damaging Yin". The common syndromes were turbid toxin, deficiency of stomach Yin, stagnation of liver and stomach, stagnation of liver and stomach Qi, obstruction of stomach collaterals and blood stasis, and weakness of spleen and stomach. Common medicines are Lobeliae Chinensis Herba, Scutellariae Barbatae Herba, Amomi Fructus Rotundus, Amomi Fructus, Poria, Isatidis Radix, Artemisiae Scopariae Herba, Scorpio, Coptidis Rhizoma, Lilii Bulbus, Linderae Radix, Phragmitis Rhizoma, Ophiopogonis Radix, Pogostemonis Herba, Eupatorii Herba, Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus. Common prescriptions are Baihe Wuyao Powder, Danggui Shaoyao Powder, Xiaoyao Pills, Xiangsu Powder, Dachengqi Decoction, Zuojin Pills, Qingzhong Decoction, Zhishi Daozhi Pills, etc. The application of latent structure model and correlation analysis in the empirical study of famous and veteran Chinese medicine experts is in line with the research direction of modern Chinese medicine "traditional Chinese medicine + X". The conclusions obtained effectively tap the experience of famous and veteran TCM experts, and provide a data and visual clinical reference and prescription compatibility for young TCM physicians in the treatment of chronic atrophic gastritis based on syndrome differentiation.

Prescription patterns of traditional Chinese medicine amongst Taiwanese children: a population-based cohort study

BackgroundTraditional Chinese medicine (TCM) has been used by Chinese patients and in many other countries worldwide. However, epidemiological reports and prescription patterns on children are few.MethodsA cohort of 178,617 children aged 18 and under from one million randomly sampled cases of the National Health Insurance Research Database was analyzed for TCM prescription patterns. SAS 9.1 was applied and descriptive medicine utilization patterns were presented.ResultsThe cohort included 112,889 children treated by TCM, with adolescents (12- to 18-year-olds) as the largest group. In the children’s TCM outpatient visits, Chinese herbal remedies were the main treatment. The top three categories of diseases treated with Chinese herbal remedies were respiratory system; symptoms, signs, and ill-defined conditions; and digestive system. The top three categories using acupuncture were: injury and poisoning, diseases of the musculoskeletal system and connective tissue, and diseases of the respiratory system. Of the top ten herbal medicines prescribed by TCM physicians, the top nine herbal formulae and the top ten single herbs were associated with diseases of the respiratory system.ConclusionThis study identified patterns of TCM prescriptions for children and common disease categories treated with TCM. The results provide a useful reference for health policy makers and for those who consider the usage of TCM for children.

Distribution of Xin'an TCM physicians and their medical works and the reasons of its formation of medical center

Based on the living times, native places and medical works of Xin'an TCM physicians described in the Xin an ming yi kao(Textual Research of Famous Physicians of Xin'an Region), the geographical distribution of ancient TCM physicians was analyzed by using Excel software. It is found that Xin'an medicine was originated from the Eastern Jin Dynasty and highly developed in the Qing Dynasty, and the number of its TCM physicians in the Ming and Qing Dynasties was large than the summation of those from the Eastern Jin Dynasty to the Ming Dynasty. In regard to the district, the distribution of Xin'an TCM physicians was characterized by more in the southeastern and less in the northwestern parts, forming a distribution area concentrated in the three counties of Shexian, Wuyuan and Xiuning. The reasons of such concentration of Xin'an TCM physicians are closely related to the economic growth, the influence of Neo-Confucianism and the density of population.

Ten-day Periodical of Traditional Chinese Medicine and its concept of confluence of Chinese and western medicine

The Ten-day Periodical of Traditional Chinese Medicine, a TCM Journal founded by the Xiamen Professional School of Traditional Chinese Medicine in July 1934, had published a lot of essays written by many TCM physicians that interpret the concept of traditional Chinese medicine by western medicine, offering the academic way of probing confluence of Chinese and Western Medicine in Xiamen. The aim of the Journal includes "developing TCM academy" and the "confluence of TCM with western medicine" , the exploration of TCM and the penetration of Chinese and western medicine, and getting rid of blind faith on "science" to set up the belief of TCM and to prove the ideas of visceral theory and its gasification by the anatomical knowledge of western medicine. The Journal envisaged the difference between the TCM and WM, avoided blind convergence, representing the academic inheritance and progress of the era. Although the essays published might have made a forced analogy by over-praising TCM, however, its exploration and convergence of TCM and the experiences are helpful to modern scholars to properly manage the relation of TCM and WM to face the future challenge consciously.

Integrated traditional Chinese medicine for childhood asthma in Taiwan: a Nationwide cohort study.

BackgroundTraditional Chinese medicine (TCM) is the most commonly used alternative therapy in children with asthma, especially in the Chinese community. This study aimed to investigate the effects of the government-sponsored Outpatient’s Healthcare Quality Improvement (OHQI) project with integrated TCM treatment on childhood asthma.MethodsThis study used the Longitudinal Health Insurance Database 2000, which is a part of the Taiwan National Health Insurance Research Database (NHIRD). Children with diagnosed asthma and aged under 15 years from 2006–2010 were enrolled. They were collated into 3 groups: (1) subjects treated with non-TCM; (2) subjects treated with single TCM; and (3) subjects treated with integrative OHQI TCM. The medical visits and the cost of treatment paid by the Bureau of National Health Insurance (BNHI) to the outpatient, emergency room, and inpatient departments were evaluated for the study subjects within 1 year of the first asthma diagnosis during the study period.ResultsFifteen multi-hospitals, including 7 medical centers, and 35 TCM physicians participated in OHQI during the study period. A total of 12850 children from the NHIRD database were enrolled in this study, and divided as follows: 12435 children in non-TCM group, 406 children in single TCM group, and 9 children in integrative OHQI TCM group. Although the total medical cost paid by the BNHI per patient in the integrative OHQI TCM group was greater than that in the non-OHQI groups, the patients in the integrative OHQI TCM group exhibited greater therapeutic effects, and did not require ER visits or hospitalization. In addition, ER visits and hospitalization among patients who received a combination of conventional therapy with integrated TCM were lower than those among patients who underwent conventional therapy alone or single TCM treatment.ConclusionsAsthmatic children at partly controlled level under conventional therapy may benefit from adjuvant treatment with integrated TCM.

Possibility of quantifying TCM finger-reading sensations: II. An example of health standardization

Aim of this studyThrough the use of a Bi-Sensing Pulse Diagnosis Instrument (BSPDI) to quantify the finger-reading skills and sensations of TCM physicians, this study was intended to determine whether a subject defined as healthy by Western medicine could be confirmed by the Three Positions and Nine Indicators Health Rule of Thumb (TPNI-HRT) regarding QI circulation. Materials and methodsAccording to the definitions of TCM, Zangfu possesses the spreading, escalating, descending, and reservation properties characteristic of whole-body QI circulation. These properties create the TPNI-HRT, which describes the sequential appearance of a pulse at the distal-middle-proximal (CUN-GUAN-CHI) positions in the wrist artery as the fingertip displacement moves from superficial (Fu) to deep (Chen). ResultsA total of 50 male undergraduates (age 19.3±1.1years) in the Taiwan Air Force Academy in excellent health demonstrated normal pulses according to cardiovascular kinetics. The BSPDI was used to mimic the TCM physicians’ finger-reading skills, and the TPNI-HRT agreement ratio between the finger-reading sensations of TCM physicians and the BSPDI measurements was 94% (34:36 pulse appearances). ConclusionsThrough the use of BSPDI to evaluate the holistic QI circulation, only 4% of the 50 patients in this study demonstrated both excellent health according to Western medicine standards and completely met the conditions of the TPNI-HRT. This result suggests that there should be consideration as to whether the TPNI-HRT should be included in standard health examinations as well as whether TCM researchers should adopt quantitative TCM methodologies rather than utilizing the quantitative tools of Western medicine.

Possibility of quantifying TCM finger-reading sensations: I. Bi-Sensing Pulse Diagnosis Instrument

Aim of this studyThis paper reports the construction and functionality of a newly designed Bi-Sensing Pulse Diagnosis Instrument (BSPDI) with a Pressure-Displacement Bi-Sensing System (PDBSS) coupled to a robot finger system. The BSPDI is used to simulate the three positions and nine indicators (TPNI) using the finger-reading rule, which addresses the three levels of superficial (Fu), medium (Zhong), and deep (Chen) at the three positions of distal (CUN), middle (GUAN) and proximal (CHI) on the wrist during pulse diagnosis. Materials and methodsA strain gauge and polyvinylidene fluoride pressure sensor were integrated as a PDBSS to separately record finger-reading skills and sense a physician's fingertip sensations. The corresponding sensation and pulse-taking displacement between the physician's fingertips and the BSPDI and the relationship between the pulse diagnosis and the nine TPNI displacements were used to determine the feasibility of the BSPDI. ResultsTPNI displacements, representing a physician's finger-reading skill, were recorded using a PDBSS. In this scenario, the BSPDI robot fingertips with pressure sensors were placed at the nine recorded TPNI displacements. The pressure sensors recorded pulse signals to simulate a physician's fingertip sensations. Two groups of participants with different health statuses were evaluated by both the BSPDI and TCM physicians. Both groups received similar diagnoses, and the results of a two-way ANOVA indicated that pulse diagnoses were highly related to the clinical experiences of the pulse-taking displacements and positions. ConclusionsThe novel BSPDI can be used to successfully mimic a TCM physician's finger-reading skill, as this technique obtained pulse signals at the nine TPNI displacements representing fingertip sensations.

A Study of the Law of Herbal Administration in Treating Lung-distension by TCM Physicians through History Using Cluster Analysis

To review the herbal drugs used most often for treating lung-distension by determining those used by physicians throughout history; to study their property, taste, and channel tropism; and to explore their compatibility. Historical prescriptions for treating lung-distension were collected and sorted. Property, taste and channel tropism were determined, and the law of herbal administration was determined by cluster analysis. One hundred and ninety five prescriptions were found, involving 166 herbal drugs, with a total appearance frequency of 1296 drugs. The herbs involved 8 properties (total appearance frequency, 1296), 7 forms of taste (total appearance frequency, 1991) and involved all 12 regular channels (total appearance frequency, 3382). Sixteen herbal drugs were used most often and formed 4 cluster prescriptions: C1: Xing Ren (Semen Armeniacae Amarum), Gan Cao (Radix Glycyrrhizae), and Ban Xia (Rhizoma Pinelliae); C2: Gui Zhi (Ramulus Cinnamomi), Wu Wei Zi (Fructus Schisandrae), and Sheng Jiang (Rhizoma Zingiberis Recens); C3: Da Zao (Fructus Jujubae), Ma Huang (Herba Ephedrae), and Shi Gao (Gypsum Fibrosum); and C4: Chen Pi (Pericarpium Citri Reticulatae), Jie Geng (Radix Platycodi), Fu Ling (Poria), Sang Bai Pi (Cortex Mori), Xi Xin (Herba Asari), Gan Jiang (Rhizoma Zingiberis), and Bai Shao (Radix Paeoniae Alba). In treating lung-distension, phlegm retention has been traditionally considered the underlying pathology, emphasizing regulation of the lung and spleen as key and stressing patient nourishment and mental improvement. Prescriptions for lung-distension should be made with reference to the property, taste, channel tropism, and effectiveness of the chosen herbal drugs.

Study on the Drug Selection Law for Treatment of Chronic Gastritis with Spleen Deficiency and Stomach Dryness by Complex System Entropy Cluster

To study on Prof. GAO Zhong-ying's drug selection law for treatment of chronic gastritis with data mining technique. The 407 medical records of chronic gastritis treated by Prof. GAO Zhong-ying were collected and the study on these drugs in the recipes was carried out with data mining method. Among them, the recipe composed of one drug was studied with frequency statistical method, correlativity between drug pairs with improved mutual information, correlativity among multi-drugs with complex system entropy cluster technique. In treatment of chronic gastritis by Prof. GAO Zhong-ying there were 30 drugs with a higher use frequency of over 38 times, 94 commonly-used drug pairs with correlation coefficient of over 0.05, 11 commonly-used drug core combinations. The results attained with data mining technique for studying experience of famous and old TCM physicians conform to the clinical practice and the method is of an important significance for summarization of famous and old TCM physicians' experiences.