Traditional Chinese Medicine In Patients Research Articles

The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study

BackgroundMany patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan.MethodsWe analyzed a cohort of one million individuals randomly selected from the National Health Insurance Research Database in Taiwan. We included 46,337 subjects with newly diagnosed DUB (ICD-9-CM codes 626.8) from January 1, 1997 to December 31, 2010. The patients were categorized into TCM seekers and non-TCM seekers according to their use of TCM.ResultsAmong the subjects, 41,558 (89.69%) were TCM seekers and 4,779 (10.31%) were non-TCM seekers. Patients who were younger tended to be TCM seekers. Most of the patients had also taken Western medicine, especially tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). More than half of TCM seekers (55.41%) received combined treatment with both Chinese herbal remedies and acupuncture. The most commonly used TCM formula and single herb were Jia-Wei-Xiao-Yao-San (Bupleurum and Peony Formula) and Yi-Mu-Cao (Herba Leonuri), respectively. The core pattern of Chinese herbal medicine for DUB patients consisted of Jia-Wei-Xiao-Yao-San, Xiang-Fu (Rhizoma Cyperi), and Yi-Mu-Cao (Herba Leonuri).ConclusionsTCM use is popular among patients with DUB in Taiwan. Further pharmacological investigations and clinical trials are required to validate the efficacy and safety of these items.

Efficacy of Chinese herbal medicine compared with metformin for glucose regulation and cardiovascular risk factors in patients with type 2 diabetes with dyslipidaemia: a multicentre, randomised clinical trial

BackgroundPrevious studies have showed that traditional Chinese medicine can regulate glycaemia, bodyweight, lipids, and blood pressure in populations with various different cardiovascular risk factors. Yet no studies have established the benefits of traditional Chinese medicine in patients with type 2 diabetes with dyslipidaemia and abdominal obesity. We aimed to assess the efficacy and safety of the Jiangtangtiaozhi decoction (known as JTTZF), a Chinese herbal medicine, on glycaemia, lipids, and weight variables, compared with metformin. MethodsWe did a randomised, multicentre, clinical trial in nine research centres in China. Adult patients (aged 18–70 years old) with type 2 diabetes and dyslipidaemia (defined as triglyceride 1·70–5·65 mmol/L−1) inadequately controlled by diet and exercise were enrolled. Patients were randomly allocated (1:1) via a computer-generated randomisation sequence to receive JTTZF (30·00 g, twice per day) or metformin (0·25 g, three times a day) for 48 consecutive weeks. Patients were treated with gliclazide sustained-release tablets once per day when their HbA1c was more than 7% after 24 weeks. If their triglyceride was more than 5·65 mmol/L−1, bezafibrate was given twice a day. Patients and clinicians were masked to group assignment. The primary endpoint was change from baseline to week 48 of mean HbA1c in each treatment group. Secondary endpoints included lipid concentrations (ie, triglyceride, total cholesterol, LDL, and HDL), waist circumference, bodyweight, and BMI. Analyses were done in the per-protocol population who complied with the protocol and had no violations. Percentages of patients that reached HbA1c targets (<7·0%) and lipid targets (triglyceride <1·7 mmol/L, total cholesterol <5·7 mmol/L) were also assessed. Ethical approval was granted by the Guang'anmen Hospital Medical Ethics Commission in Beijing, China. Informed patient consent was given by all participants. This study is registered with ClinicalTrials.gov, number NCT01471275. FindingsBetween Nov 25, 2011, and Jun 27, 2013, we randomly assigned 450 patients to either JTTZF (n=225) or to metformin (n=225). 378 patients were included in the per-protocol analysis (201 patients in the JTTZF group and 177 patients in the metformin group). At week 48, JTTZF reduced mean HbA1c to 7·30% (SD 1·21, −0·94% from baseline) and metformin reduced mean HbA1c to 7·23% (SD 1·15, −1·00% from baseline; p=0·55 for difference between groups). 46% of patients attained the HbA1c goal in the JTTZF group and 41% in the metformin group. Compared with metformin, JTTZF did not significantly reduce mean concentrations of triglycerides (−0·87 mmol/L, SD 2·73 in the JTTZF group vs −0·53 mmol/L, 2·33 in the metformin group; p=0·19), total cholesterol (−0·53 mmol/L, 1·36 vs −0·39 mmol/L, 1·27; p=0·324), LDL (−0·45 mmol/L, 1·00 vs −0·33 mmol/L, 0·82; p=0·204), and HDL (−0·08 mmol/L, 0·43 vs −0·06 mmol/L, 0·27; p=0·54). More patients in the JTTZF than the metformin group reached targets for triglycerides (42% vs 28%, p=0·007) and total cholesterol (78% vs 69%, p=0·047). After 48 weeks, compared with metformin, JTTZF decreased mean waist circumference (−4·15 cm, SD 5·41 vs −2·95 cm, 5·70; p=0·036), bodyweight (−2·72 kg, SD 4·29 vs −1·75 kg, 4·31; p=0·029), and BMI (−0·99 kg/m2, SD 1·55 vs −0·62 kg/m2, SD 1·59; p=0·021). Serious adverse events were reported in four (2%) of 225 patients in the JTTZF group and in six (3%) of 225 patients in the metformin group. No severe hypoglycaemia was reported in either group. InterpretationJTTZF showed improvements in several cardiovascular risk factors compared with metformin. JTTZF might be a promising alternative treatment for patients with type 2 diabetes. FundingSpecial Scientific Research for Traditional Chinese Medicine of China.

Utilization and prescription patterns of traditional Chinese medicine for patients with hepatitis C in Taiwan: a population-based study.

BackgroundTo characterize the utilization of Traditional Chinese Medicine (TCM) among patients with hepatitis C (HC).MethodsThis study examined datasets from the National Health Insurance Research Database in Taiwan. One cohort, including one million patients randomly sampled from the beneficiaries of the National Health Insurance Programme from January 1 to December 31 in 2010, was chosen for this analysis. People who had at least three outpatient or inpatient records and had been diagnosed with hepatitis C virus infection from 2000 to 2010 were defined as patients with HC. Patients with HC who had at least one TCM outpatient clinical record from 2000 to 2010 were defined as TCM users (N = 5,691), whereas patients with no TCM outpatient records were defined as non-TCM users (N = 2,876). The demographic data, treatment modalities and disease distributions of TCM users were analysed.ResultsOverall, 66.4 % of the patients with HC had used TCM from 2000 to 2010. Of the TCM users, 54.1 % were female. The utilization rate of TCM increased with age and peaked in the age group of those 40 − 64 years old. Herbal remedies (52.4 %) were the most commonly used agents, followed by combination therapy (46.4 %) and acupuncture alone (1.2 %). Patients who had more extrahepatic diseases and were taking more antiviral agents tended to visit TCM clinics. Jia-Wei-Xiao-Yao-San and Dan-Shen (Salvia miltiorrhiza) were the most commonly used formula and single herb, with 88,124 person-days and 59,252 person-days, respectively.ConclusionsOur nationwide population-based study revealed a high prevalence and specific usage patterns of TCM in patients with HC in Taiwan.

Effects of Intermittent Pressure Imitating Rolling Manipulation on Calcium Ion Mediation in Human Skeletal Muscle Cells

The key of skeletal muscle injuries is the homeostasis imbalance of Ca2+ in the skeletal muscle cells. Such imbalance can cause the significant changes of the biomarkers of skeletal muscle metabolism such as decreased superoxide dismutase (SOD), and increased malondialdehyde (MDA) and creatine kinase (CK). Measurements of these biomarkers can be used to evaluate the damage degree of human skeletal muscle cells (HSMCs) and their relation to Ca2+ level. Rolling manipulation is the most popular myofascial release technique in Traditional Chinese Medicine for patients with muscular dysfunctions, but it is still unknown how the rolling manipulation through its mechanic pressure to make biological effect on the local muscle tissue. Therefore, this study was to investigate the Ca2+ mediated effects of intermittent pressure imitating Rolling manipulation (IPIRM) of Traditional Chinese Medicine on the human skeletal muscle cells (HSMCs).

&lt;b&gt;内リンパ水腫の東洋医学的病態について&lt;/b&gt;

内リンパ水腫はメニエール病の指標であり，近年MRI によって診断できるようになった。東洋医学では内リンパ水腫を水毒の病態と考え利水剤が投与されることが多いが，内リンパ水腫が水毒の病態かどうかは実際の症例では検証されていない。今回MRIで内リンパ水腫と診断された11症例を中医学で弁証し，また，水毒および水毒の眩暈の病態を文献で検証した。自験例では，津液の病証7例，腎の病証8例，肝の病証5例であった。文献的には，『金匱要略』の痰飲咳嗽病・水気病篇の条文が水毒による眩暈の病態を表しているとされている。しかし，痰飲咳嗽病篇の眩暈の条文には蝸牛症状の記載がなく，蝸牛症状を伴うメニエール病とは異なる病態である可能性もある。自験例や文献の考察からは，内リンパ水腫は必ずしも水毒の病態とは限らず，腎や肝の病証も考慮し弁証する必要があると示唆された。

The Relationship between Body Weight Change and Body Constitutions of Traditional Chinese Medicine in Patients with Schizophrenia.

Objective. To explore the relationship between body constitution (BC) types and weight change in patients with schizophrenia and who underwent second-generation antipsychotics (SGAs) treatment. Method. Body weight and waist circumference of eighty-five participants were measured for 6 consecutive weeks. Constitutions of Yin-Xu, Yang-Xu, and Stasis were assessed using the Body Constitution Questionnaire (BCQ). Results. Participants with body constitutions Yin-Xu (50.6%), Yang-Xu (49.4%), or Stasis (38.8%) exhibited worse physical condition and unhealthy daily habits, particularly in Stasis constitution. Moreover, Stasis constitution was significantly associated with several factors, including BMI, body weight, waist circumference, perception of stress, perception of health, staying up late, and less physical exercise. However, perception of stress showed significant difference in Yin-Xu, Yang-Xu, and Stasis. Generalized estimating equation (GEE) analysis revealed that significant time effects in body weight increase in the imbalanced BC types and gentleness BC type. SGAs induced weight gain in imbalanced BC type as well as gentleness BC type, especially treated with olanzapine. Conclusions. This is the first study to explore the longitudinal relationship between BC and weight gain in schizophrenia patients undergoing SGAs treatment. Health care providers should focus on weight gain problems in schizophrenia patients who underwent SGAs treatment.

Therapeutic effects of traditional Chinese medicine in patients with symptomatic cervical ectopy

PurposeThe aim of this study is to evaluate the treatment and efficacy of Badushengjigao, a traditional Chinese medicine (TCM) formula, for symptomatic cervical ectopy. MethodA patient self-selected two group comparison study was performed. One hundred patients with symptomatic cervical ectopy admitted to the Central Hospital of E-Zhou (Hubei, China) between July 2013 and July 2014 were enrolled in the study. The patients treated with Badushengjigao were the study group and the patients treated with policresulen suppository were the control group. The medicine was administered through vagina. Patients received a three-month follow-up (once a month). The treatment results were evaluated and analyzed by variance analysis and X2 test. ResultsThe curative rates of the two groups with symptomatic cervical ectopy grade 1 shows no statistical significance. As for grade 2 and grade 3, the curative rates of the study group (phase 2: 72.0%; phase 3: 62.5%) are higher than that of the control group (phase 2: 44.4%; grade 3: 54.5%) with statistical difference (P<0.05). The study group has less adverse effects (2.5±1.3 days of vagina bleeding, 6 cases of abdominal pain and 2 cases of increased discharge) than the control group (12.5±1.1 days of vagina bleeding, 15 cases of abdominal pain and 42 cases of increased discharge) with distinctive statistical difference (P<0.01). ConclusionThe TCM formula, Badushengjigao, seems to be more effective than policresulen suppositories in treating symptomatic cervical ectopy phase 2 and phase 3. We suggest that it could be used as an alternative method for symptomatic cervical ectopy treatment, but further study is needed.

Use of traditional Chinese medicine in patients with hyperlipidemia: A population-based study in Taiwan

Ethno-pharmacological relevanceChinese herbal products (CHPs) are commonly used in patients with hyperlipidemia in traditional Chinese medicine (TCM). Because hyperlipidemia and related disease are common issues worldwide, this study analyzed the prescription patterns and frequencies of CHPs for treating patients with hyperlipidemia in Taiwan. BackgroundTraditional Chinese medicine (TCM) has become popular as a therapy for controlling symptoms in patients with hyperlipidemia. This study aimed to analyze the prescription patterns of TCM for patients with hyperlipidemia in Taiwan. MethodsThe study population was recruited from a random-sampled cohort of 1,000,000 people from the National Health Insurance Research Database between 2003 and 2009. We identified 30,784 outpatient visits related with hyperlipidemia diagnosis and collected these medical records. Association rules of data mining were conducted to explore the co-prescription patterns for Chinese herbal products (CHPs). ResultsThe most commonly prescribed herbal formula for hyperlipidemia treatment was Xue-Fu-Zhu-Yu-Tang (16.1%), and Shan Zha (Crataegi fructus; 25.0%) was the most commonly prescribed single herb. The most commonly prescribed combination of an herbal formula and a single herb was Xue-Fu-Zhu-Yu-Tang and Dan Shen (Radix Salviae Miltiorrhizae), and the most commonly prescribed combination of couplet herbs was Dan Shen and Shan Zha. ConclusionXue-Fu-Zhu-Yu-Tang is the most frequently prescribed formula and is typically prescribed with Shan Zha, Dan Shen, and He Shou Wu for patients with hyperlipidemia. Clinical trials are warranted in future research to investigate the effects of the CHPs in terms of safety and efficacy and in particular to evaluate potential interactions with conventional treatments.

Preliminary study on integration of traditional Chinese medicine and western medicine in patients with coronary heart disease in real world

Observe and analyze the informations of western medicine and traditional Chinese medicine in patients with coronary heart disease (CHD), in order to provide reference for clinical treatment. Select patients with CHD in diagnosis of the first place in 17 hospitals, drug informations of these patients were analyzed using frequency method and association rules. In 84 697 patients,there were 47 564 males and 32 882 females. The median age was 71 years old, 76 172 patients have medicine records, including 278 kinds of western medicine and 331 kinds of traditional Chinese medicine. Aspirin was the most common used western medicine (51 132 patients, 67.08%), followed by isosorbide dinitrate, clopidogrel etc. The most common used traditional Chinese medicine was danhong injection, followed by shuxuetong injection. After classified the drugs, at the forefront of western medicine were antiplatelet drugs, nitrates drugs, statins, beta blockers, calcium antagonists, ACEI; the most used in traditional Chinese medicine was injection of blood-activating and stasis-resolving, followed by oral preparations of blood-activating and stasis-resolving medicine, Fuzheng class oral medicine, purgation medicine etc. After association rules, combination therapy among western medicine was the most common, combination of western medicine with blood-activating and stasis-resolving was very commonly, especially antiplatelet drugs and nitrates drugs. Western medicine in the treatment of patients with CHD was in accordance with the guidelines recommend, but with the lower utilization rate. Traditional Chinese medicine has become an important method for the treatment of CHD, promoting blood circulation and removing blood stasis is an important part of traditional Chinese medicine treatment in patients with CHD.

Refractory cytopenia of children and acquired aplastic anemia: a clinical and pathological study of 130 cases

To explore the clinical characteristics and histopathological morphology features of bone marrow biopsies between refractory cytopenia of children (RCC) and acquired aplastic anemia (AAA) to facilitate the diagnosis, differential diagnosis and treatment of RCC and AAA. We retrospectively analyzed clinical data and histopathological morphology of bone marrow biopsies in RCC or AAA patients referred to our hospital from January 2011 to December 2012. There were totally 130 patients studied. The final diagnoses of them were RCC in 78 cases (60.0%) and AAA in 52 cases (40.0%). The median WBC count, absolute neutrophil count, blood platelet count, hemoglobin level, and reticulocyte count were all higher in RCC children than AAA (P<0.01). All of RCC patients showed hypocellular biopsy specimens, and 84.6% (66/78) of them had cellularity of bone marrow biopsy specimens ranging from 20% to 60%. Patchy pattern distribution was seen in 98.7% (77/78) of RCC cases, and micromegakaryocyte was found in 61.5% (48/78) of RCC cases. All of AAA patients showed severe hypocellular biopsy specimens, and 88.5% (46/52) of them had cellularity of bone marrow biopsy specimens under 5%. Megakaryocyte was not found in 98.1% (51/52) of AAA cases. The response rates of immunosuppressive therapy using CsA ± rabbit anti- thymocyte globulin ± androgen ± traditional Chinese medicine for patients with RCC and AAA were 59.5% and 26.9% at 3 months (P=0.011), and 75.0% and 38.1% at 6 months, respectively (P=0.007). RCC patients showed milder cytopenia and bone marrow hyperplasia than AAA. Patchy distribution of hematopoietic cells, erythroid islands with a marked left shift and micromegakaryocytes were decisive histomorphological patterns used to separate RCC from SAA. Immunosuppressive therapy using CsA ± rabbit anti- thymocyte globulin ± androgen ± traditional chinese medicine was an effective therapy in patients with RCC and AAA, and the outcome of immunosuppressive therapy for RCC patients was superior to that of AAA patients.

Characteristics and prescription patterns of traditional Chinese medicine in atopic dermatitis patients: Ten-year experiences at a Medical Center in Taiwan

Complementary and alternative therapies in treating atopic dermatitis are not uncommon. However, substantial evidence and consensus on treating atopic dermatitis is lacking. The aim of this study is to investigate the characteristics and utilization of traditional Chinese medicine in patients with atopic dermatitis. We retrospectively collected patients with atopic dermatitis at the Chang Gung Memorial Hospital in Taiwan between 2002 and 2011. Patients' demographic data, duration and frequency of treatment, serum total immunoglobulin E levels, and traditional Chinese medicine treatment principles and prescription were analyzed. There were 4145 patients (8.8%) received traditional Chinese medicine therapy between 2002 and 2011. Among them, 2841 (68.54%) chose TCM only and 1304 (31.46%) chose to combine TCM and WM therapies. Those who chose combination therapy were younger, and needed more times of visit and longer duration of treatment. The most frequent comorbid conditions accompany atopic dermatitis were allergic rhinitis (46.06%) and asthma (21.46%). Among the 87,573 prescriptions written for Chinese medicine, the most frequently prescribed herbal formula and single herb were Xiao-Feng-San (Eliminate Wind Powder) (16.98%) and Bai-Xian-Pi (Cortex Dictamni) (12.68%), respectively. The most commonly used therapeutic principles of herbal formulas and single herbs were releasing exterior (20.23%) and clearing heat (41.93%), respectively. Our hospital-based study characterized the utilization patterns of traditional Chinese medicine in atopic dermatitis patients. This information could be used as references for clinical application and provide valuable information for future clinical trials.

Utilization of traditional Chinese medicine in patients treated for depression: A population-based study in Taiwan

Traditional Chinese medicine (TCM) has been used to treat depression-like symptoms in Taiwan. We aim to examine factors associated with utilization of TCM in patients with depression and to test whether the use of TCM would impact the use of psychiatric services with a subsequent impact on healthcare costs. Adult patients (n = 216,557) who received antidepressant treatment for depression in 2003 was identified in the National Health Insurance Research Database in Taiwan. A Two-Part model was conducted. A multivariate logistic regression was employed to explore factors associated with the use of TCM, with a particular focus on baseline comorbidities, painful physical symptoms (PPS), and frequency of psychiatric service contacts over the ensuing 12-month study period. Multivariate generalized linear modeling was then applied to examine factors associated with healthcare costs for TCM users. More than 40% of individuals prescribed with antidepressant treatments for depression used TCM services. Younger age, female gender, the presence of certain comorbid mental/physical illnesses or PPS, as well as having fewer psychiatric service contacts were found to be associated with the use of TCM services. These factors also affected TCM costs for users; the TCM costs equaled to 30% of costs of psychiatric out-patient services for TCM users. The current study suggested a set of significant factors which could influence use and cost of TCM services for patients with depression. Utilization of TCM services could have a substantial impact on use of psychiatric services and healthcare costs for patients with depression.

Therapeutic efficacy of traditional Chinese medicine, Shen-Mai San, in cancer patients undergoing chemotherapy or radiotherapy: study protocol for a randomized, double-blind, placebo-controlled trial

BackgroundCancer is one of the major health issues worldwide. An increasing number of cancer patients are offered treatment with surgery, chemotherapy and radiotherapy. Traditional Chinese medicine (TCM) is one of the most common complementary therapies offered to cancer patients in Taiwan. We designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of TCM in patients with cancer.Methods/designIn this study, inclusion criteria are postoperative patients with histologically confirmed cancer within 3 years who are undergoing chemotherapy or radiotherapy, more than 18 years old, have given signed informed consent, have the ability to read Chinese, and the ability for oral intake.Exclusion criteria include being pregnant, breast feeding, having completed chemotherapy or radiotherapy, brain metastasis with Eastern Cooperative Oncology Group (ECOG) performance status of two to four, delusion or hallucinations, acute infection, and have received medications under other clinical trials.The patients were separated into an intervention group (Shen-Mai-San, SMS) and a placebo group for four weeks using a randomized, double-blind procedure. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life questionnaire (QOL-C30) was used to evaluate the quality of life. General data, hemoglobin (Hb), hematocrit (Hct), glutamic-oxalacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), blood urea nitrogen (BUN), creatinine, carcinoembryonic antigen (CEA), TCM diagnosis data and heart rate variability (HRV) were also recorded. These data were collected at baseline, two weeks and four weeks after receiving medication. The patients were prescribed granules which contained therapeutic medicines or placebo. Paired-T test was used for statistical analysis.DiscussionShen-Mai-San is composed of processed Ginseng radis, Liriope spicata, and Schizandrae fructus. It was found to be effective for treating cancer-related fatigue and had anti-fatigue activity. In TCM theory, SMS has a synergistic effect for qi and yin deficiency and has the ability to prevent fatigue. The symptoms of qi and yin deficiency are similar to chemotherapy- or radiotherapy-induced side effects. In order to evaluate the efficacy of SMS on cancer treatment, we designed a randomized, double-blind, placebo-controlled trial.Trial registrationThis study is registered to Clinical Trails.gov NCT01580358

Application of dialectical nursing of traditional Chinese medicine in patients with gout

Objective To explore the application of dialectical nursing of traditional Chinese medicine in patients with gout.Methods Totals of 68 cases with gout were randomly divided into control group( n =36)and observation group (n =34).Types such as wet- hot,heat and blood stasis block,phlegm,yin deficiency of liver and kidney of cases were divided.The observation group received the dialectical nursing and selfdesigned special care programs,many special form were used such as drawing the blood uric acid detection curve,symptom observation,daily diet records list,daily medication and external treatment record.Then,the time of symptoms better,effective,cure were observed and diet,living,grooming emotion were strictly guidanced.Control group only rceived the dialectical nursing without self-designed nursing program.Results The time of blood uric decrease to normal of observation group significantly short than that of control group(15.0 ±2.5) d vs (22.0 ±7.5) d,(t =5.1629;P ＜0.05).The whole effective cases number of observation group was significantly more than that of control group ( 33 vs 26 ),( x2 =4.6102 ; P ＜ 0.05 ).Conclusions Dialectical nursing application,detailed records in every day,strict implementation of the living,diet,emotional guidance for the patients with gout have positive clinical influencing. Key words: Primary gout; Dialectical nursing; TCM nursing

Assessment of external methods of traditional Chinese medicine in patients with chronic ulcer of the lower extremities: study protocol of a multicenter, randomized, parallel-group, prospective trial

Chronic ulcer of the lower extremities amounts for a grave and serious problem for public health. Western medicine focuses on controlling infection, improving blood circulation, surgical debridement, skin grafting, etc, but there are bottlenecks in the treatment. Traditional Chinese medicine (TCM) has a long history and a legacy of sound clinical efficacy in this area. TCM has developed a unique, effective external theory, and a large number of topical prescriptions and external technology. Through this research, a safe and effective treatment protocol of TCM for chronic ulcer of the lower extremities can be formed. To this end, during China's "Eleventh Five-Year" Plan, special research committees and projects on TCM external treatments and external technologies were established. This study on ulcer of the lower extremities constitutes one of the major research topics. Clinical information of patients with chronic ulcer of the lower extremities will be first collected in a large, multicenter, epidemiological survey. Concurrently, a large multicenter, randomized, parallel-group, prospective study will be launched based on evidence-based medical principles to evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration. The evaluated indexes will include the wound healing percentage for primary outcome, wound healing time, wound healing rate, time and rate of removal of necrotic tissue, and TCM syndromes for secondary outcomes and routine blood test, routine urine test, liver and kidney function, blood mercury content and finally urine mercury content for adverse events. In this trial, the authors will evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration in cases of chronic ulcer of the lower extremities for standardizing external therapy of TCM for treatment of this condition, and establishing the clinical assessment system for TCM. The research program was registered in the Chinese Clinical Trial Registry in both English and Chinese in June 2011. ChiCTR-TRC-11001365.

Síndrome das Pernas Inquietas: Visão da Medicina Chinesa

Introduction. Restless Legs Syndrome (RLS) is a sleep disorder that causes great discomfort, and that has no definite treatment yet. Tra ditional Chinese Medicine (TCM) is an ancient therapeutic modality in use for thousands of years and that has been occupying more and more space on scientific and academic communities. Objective. The main goal of this paper is to present the TCM view of RLS, presenting possible etiologies and Syndrome Differentiation, in order to compare with the Western knowledge. Method. Literature review. Conclusion. TCM has a very peculiar view of health, using a very own terminology that can many times confound the westerners not familiarized with its terms. Only few studies have been conducted to verify the results of treatments based on TCM in patients with RLS. It is recommended that studies with more rigorous methodologies, such as randomized, controlled, blinded, clinical trials, with an adequate number of patients, should be conducted.

A study of diagnostic criteria for traditional Chinese medicine syndromes in osteoporosis

To establish diagnostic criteria for common traditional Chinese medicine (TCM) syndromes in osteoporosis. Based on the collection and analysis of related medical literature, clinical investigation, and expert discussion, a draft of preliminary diagnostic criteria for the basic syndromes of TCM in patients with osteoporosis was formulated. Then it was used in clinic for verification and revised repeatedly until a formal version of diagnostic criteria was satisfactorily achieved. The basic syndromes listed in the diagnostic criteria for patients with osteoporosis consisted of two parts: qualitative diagnosis and localization diagnosis. Results of qualitative diagnosis showed that the qualitative syndromes included damage of essence, deficiency of vital energy, deficiency of yin, deficiency of yang and blood stasis. The localization diagnosis showed that location of osteoporosis is bone and corresponds to the kidney, and also involves liver, lung, spleen (stomach) and heart. The diagnostic content has established the specific symptoms and the non-specific symptoms during various stages. Each of the above syndromes could be diagnosed according to a specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio of qualitative diagnosis was 80.56% between the diagnoses made according to the criteria and the diagnoses acquired from the experts' experience, and the total matching ratio of localization diagnosis was 85.56%. The TCM syndrome diagnostic criteria for osteoporosis is generally consistent with TCM clinical practice, worthy of further popularization and application in clinical practice.

Latent class model based diagnostic system utilizing traditional Chinese medicine for patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) can affect nearly any organ system, and is frequently an evolving disease with varied manifestations. Traditional Chinese medicine (TCM) physicians have identified different SLE patterns that they have difficulty summarizing, but the latent class model helps solve this problem. This study applies the latent class model and disease pattern coding system (B-code) to design a TCM diagnostic expert system. This study gathered 2047 valid records and classified three clusters of main disease patterns. Compared with the experience of the TCM expert, the accuracy rate of the expert system reached 77.47%. The results show that this diagnostic system performed well in identifying the disease patterns of SLE and may be clinically useful for TCM physicians.

Relationship between quality of life and basic syndromes of traditional Chinese medicine in patients with posthepatitic cirrhosis

To investigate the main factors influencing the quality of life and the relationship between quality of life and basic syndromes of traditional Chinese medicine (TCM) in patients with post hepatitic cirrhosis. The outcomes of revised Short Form-36 Health Survey (SF-36) Questionnaire in 108 patients with post hepatitic cirrhosis and the normal control population were assessed, and the related clinical information including gender, age, body mass index (BMI), course of disease, basic syndromes of disease and main laboratory parameters were collected. The data were analyzed by t-test, analysis of variance (ANOVA) and stepwise regression analysis. The Cronbachs alpha coefficient of the revised SF-36 questionnaire was 0.773, indicating good consistency within the items. The outcomes of revised SF-36 and the scores of physical function, role physical, bodily pain, mental health, and social function in the patients with post hepatitic cirrhosis were significantly lower than those in the normal control population (P<0.01). Correlation analysis showed that there was a correlation between basic TCM syndromes and scores of physical function, mental health, role emotion, vitality, and general health. Stepwise regression analysis indicated that basic TCM syndromes, aspartate aminotransferase, total bilirubin, albumin, and prothrombin time played major role in the quality of life in the patients with post hepatitic cirrhosis, and the values of regression coefficient were 0.262, -0.297 8, -0.483 9, -0.483 9, -0.512 3, -0.571 9 respectively. The quality of life in the patients with post hepatitic cirrhosis is significantly decreased. The revised SF-36 with basic TCM syndrome items is more objective and has certain clinical practical value on measurement of quality of life in patients with post hepatitic cirrhosis.

A family survey of syndromes of traditional Chinese medicine in patients with β-thalassemia

To explore the relationship between syndromes of traditional Chinese medicine (TCM) and genetic background in patients with beta-thalassemia. TCM syndromes were surveyed in the selected 78 patients with beta-thalassemia intermedia including 120 parents. The gene mutations were detected separately. The frequency and score of TCM syndromes between the offspring and their parents in different family types were analyzed, and the differences were compared. The 73 families were divided into two family types by hereditary characteristics. Family type one meant that genotypes of one of the parents were normal, while the offspring genotypes were heterozygous and were exactly the same as another parent. In the 22 families of type one, the heterozygous offspring manifested 6 high-frequency symptoms and signs such as spontaneous perspiration, dry mouth and dry throat, pale or sallow complexion, tidal fever and night sweating, lassitude and pale fingernails. The heterozygous parents manifested 5 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, aversion to cold and cold limbs, tinnitus, dry mouth and dry throat. The normal parents manifested 3 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, and spontaneous perspiration. TCM syndrome score in the heterozygous offspring was higher than that in the heterozygous and normal parents, but there was no significant difference (P>0.05). Family type two meant that genotypes of both parents were heterozygous, while the offspring genotypes were heterogenic duplex heterozygotes. In the 51 families of type two, the offspring manifested 9 high-frequency symptoms and signs such as pale or sallow complexion, spontaneous perspiration, dry mouth and dry throat, pale fingernails, tidal fever and night sweating, lassitude, frequent attack of common cold, dysphoria with feverish sensation in chest, and yellow discoloration of the skin and sclera. The parents manifested 3 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, aversion to cold and cold limbs. TCM syndrome score in the offspring was significant higher than that in the parents (P<0.01). In the two family types, TCM syndrome in the offspring is of yin-blood deficiency, while the syndrome of the parents is of kidney deficiency. The differences of TCM syndromes between the offspring and the parents may have some relations to the type of mutant genes and genetically modified ingredients. This research provides scientific evidence to TCM syndrome differentiation treatment of thalassemia.