Traditional Chinese Medicine Patients Research Articles

Analysis of traditional Chinese medicine syndrome types and frequency changes of CD8+ and CD25+ T cells in metabolic-related fatty liver disease.

This study aimed to observe and analyze the changes in traditional Chinese medicine (TCM) syndrome types and CD8+ and CD25+T cell frequencies of metabolic-related fatty liver disease. For this purpose, 100 patients with metabolic-related fatty liver disease and their TCM syndrome types who were screened for medical treatment were collected. Flow cytometry was used to detect the changes in the frequency of CD8+ and CD25+T cells in the peripheral blood of patients, as well as liver function, fasting blood glucose, and lipid index. The frequency differences of CD8+ and CD25+T cells in patients with different syndrome types were compared. To use partial correlation analysis to determine the correlation between CD8+, CD25+T cell frequencies and TCM syndrome types in patients. Results showed that a total of 30 cases of liver stagnation and spleen deficiency syndrome, 25 cases of phlegm turbidity internal obstruction syndrome, 20 cases of dampness heat stasis syndrome, and 25 cases of phlegm stasis mutual accumulation syndrome were included in the 100 MAFLD patients. There was statistical significance (P<0.01) in the comparison of ALT, AST, GGT, TC, TG, HDL-C, LDL-C, FPG, HOMA-IR, CD8+CD25+, CD8+CD25-, CD8-CD25+, and CD8-CD25- among patients with different TCM syndrome types. There is a positive correlation between TCM syndrome types and patients' CD8+CD25+, CD8+CD25-, and CD8-CD25+, while there is a negative correlation between them (P<0.05). From the chord diagram, the relationship between CD8+CD25+ and TCM syndrome types is the closest. The ROC curve was used to analyze and determine that the relevant standard for CD8+CD25+ in liver depression and spleen deficiency syndrome is <4.90%; The relevant standard for phlegm turbidity internal obstruction syndrome is 4.90%~7.88%; Damp heat stasis syndrome is 7.88%~8.20%; The syndrome of phlegm and blood stasis accumulation is more than 8.20%. The TCM syndrome types of metabolic-related fatty liver disease will vary with the frequency of CD8+ and CD25+T cells. In conclusion, TCM syndrome types are closely related to the severity of the patient's condition and immune function, providing a new perspective and means for understanding the pathogenesis of metabolic-related fatty liver disease and evaluating the condition.

Realizing Holism in Traditional Chinese Medicine (TCM) Consultations through the Voice of TCM (VOTCM): An Interactional Analytical Approach

ABSTRACT In recent years, doctor-patient communication in the context of traditional Chinese medicine (TCM) has attracted increasing attention. Highly influenced by ancient Chinese philosophy, TCM is unique in its exemplification of Chinese wisdom, particularly with respect to how the idea of zhěngtǐguān (整体观) (lit. whole body concept), realized as “the idea of the whole” or simply “holism,” is valued and realized in TCM consultations. Adopting an interactional analytical approach, our study aims to illustrate how TCM doctors and patients co-construct a medical consultation that can exemplify the idea of holism. Based on a spoken corpus of Mandarin Chinese totaling 443 minutes in length, this paper identifies instances of what can be labeled as the voice of TCM (VOTCM) in a typical TCM consultation that reflect the idea of holism and describes and analyzes the communicative routines that are specific to these TCM consultations. It is observed that the steps and strategies involved in the consultation not only illustrate the collaborative co-construction of holism but also point to the holistic aspect of TCM philosophy, particularly topics related to the different body parts and the lifeworld. The diagnostic explanations provided by doctors and the co-topical talks between doctors and patients at various stages of the consultation also play an important role in the co-construction and realization of holism.

The dynamics of patient visits to traditional Chinese medicine during the 2019 coronavirus pandemic

BackgroundLarge-scale epidemics have changed people’s medical behavior, and patients tend to delay non-urgent medical needs. However, the impact of the pandemic on the use of complementary and alternative medicine remains unknown.MethodsThis retrospective study aimed to analyze the changes in the number of traditional Chinese medicine (TCM) patients and examine the epidemic prevention policy during the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the number of TCM patients in Taipei City Hospital from January 2017 to May 2020. We tallied the numbers of patients in each month and compared them with those in the same months last year. We calculated the percentage difference in the number of patients to reveal the impact of the COVID-19 pandemic on TCM utilization. We used the Mann–Whitney U test to examine whether there was a significant difference in the number of patients during the COVID-19 pandemic.ResultsWe included a total of 1,935,827 TCM visits of patients from January 2017 to May 2020 in this study. During the COVID-19 pandemic, the number of patients decreased significantly, except in February 2020. The number of patients during the COVID-19 pandemic had fallen by more than 15% compared with those in the same months last year. March and April had the greatest number of patient losses, with falls of 32.8 and 40% respectively. TCM patients declined significantly during the COVID-19 pandemic, and mobile medicine provided to rural areas fell considerably. Among all the TCM specialties, pediatrics and traumatology, as well as infertility treatment, witnessed the most significant decline in the number of patients. However, the number of cancer patients has reportedly increased.ConclusionsThe COVID-19 pandemic decreased the utilization rate of TCM, especially for mobile healthcare in rural areas. We suggest that the government pay attention to the medical disparity between urban and rural areas, which are affected by the pandemic, as well as allocate adequate resources in areas deprived of medical care.

PP369 Development Of A Dysmenorrhea Quality Of Life Scale Based On Traditional Chinese Medicine Theory: A Mixed-Methods Study

IntroductionIt is difficult to generalize health technology assessment in the field of traditional Chinese medicine (TCM). The lack of an outcomes evaluation system based on TCM theory is one of the important reasons. Studies conducted in menstruating women have shown that the prevalence of primary dysmenorrhea varies from 45 to 95 percent. As a debilitating condition for many women, dysmenorrhea is one of the leading causes of absenteeism from school or work, which has a negative effect on quality of life (QoL). TCM has obvious advantages in treating dysmenorrhea. This study aimed to develop a dysmenorrhea QoL scale based on TCM theory.MethodsWe conducted focus group discussions and in-depth interviews with TCM gynecologists and patients, and adapted items from previously published scales. We generated an initial pool of forty-one items with eight domains. The Delphi method was used for preliminary item selection. Then, we administered the items to a sample of adolescent girls (n = 200). The distribution of survey items, discrete trend, factor analysis, correlation coefficient, and Cronbach's α coefficient were used to select items.ResultsAfter two rounds of expert consultation, a total of thirty items were included in the dysmenorrhea QoL scale. And after sample analysis, four items' frequency distribution was skewed, five items' standard deviation (SD) was &lt;0.8, four items' factor loading was &lt;0.4, five items' score correlation coefficient with a related domain was &lt;0.4, and three items’ deletion would cause their domain's Cronbach's α coefficient increased. The items were deleted when they met more than two above standards.ConclusionsA total of twenty items with eight domains were included in the dysmenorrhea QoL scale. The methods to select the dysmenorrhea QoL scale items based on TCM theory were preferable. Given the paucity of research in this area, this new dysmenorrhea QoL scale may provide opportunities for patient-reported outcome evaluation in the field of TCM.

Traditional Chinese medicine use may reduce medical utility in patients with asthma: a nationwide population-based retrospective cohort study.

Many patients with atopic diseases, including asthma, have sought complementary and alternative medicine and traditional Chinese medicine (TCM) treatments. But, limited clinical studies have yet examined TCM effects on medical utility in asthma patients. To assess the medical utility of TCM in patients with asthma. Population-based retrospective cohort study. We performed a 13-year population-based retrospective cohort study. A total of 5235 asthma patients who were TCM users and 5235 propensity-score matched asthma patients who never used TCM were sampled from the Taiwan National Health Insurance Research Database from 2000 to 2012. We compared these two groups of patients to calculate their medical utility, including numbers of emergency visits and hospitalizations until 2013. Univariate analyses were performed using Chi-square tests for dichotomous variables and t-tests for continuous variables. Cox proportional hazard models were conducted to investigate the medical utility of asthma after TCM use. Compared with non-TCM patients, TCM patients had a significantly decreased medical utility of asthma admission [adjusted odds ratio (OR) = 0.63; 95% confidence interval (CI): 0.46-0.85; P < 0.05], especially in patients who used TCM for >60 days. Asthma medical utility in asthma emergencies was significantly higher for male than for female patients (adjusted OR = 1.45; 95% CI: 1.08-1.96). The most frequently used TCMs for asthma control or cough treatment were antitussive agents. This population-based retrospective cohort study showed a significantly decreased medical utility of emergency visits and admissions in TCM patients, especially using TCM for >60 days.

Understanding the Traditional Chinese Medicine (TCM) consultation: Why do patients adhere to treatment?

Backgroundand purpose: Adherence is an issue that affects Complementary and Alternative Medicine (CAM) and conventional medicine practitioners, whereby approximately half of the patients do not take their medicines or remedies as prescribed. The consultation is an opportune area where practitioners can have an impact on patient adherence to treatment. As such, research was undertaken to explore this in depth within one CAM. The aim of the study was to understand the Traditional Chinese Medicine (TCM) consultation process that occurs in relation to adherence and develop a consultation model health professionals can use. Materials and methodsA classical grounded theory approach was employed to semi-structured interviews of TCM practitioners and patients along with observations of their consultations. Sampling was theoretical and by snowball in the United Kingdom. NVivo 11 was used to assist with analysis of the transcribed interviews and observations. ResultsSeven TCM practitioners and twenty-eight patients were recruited. TCM practitioners built a therapeutic relationship through the consultation by enabling patients to feel comfortable, valued as individuals which incorporated feeling understood and known, as well as supported in the management of their health. Fundamentally, patients needed to feel cared for and have trust in their TCM practitioner for the therapeutic relationship to be established. This motivated patients to continue with treatment. ConclusionThe TCM Consultation Model for Adherence was developed to conceptualise the consultation process that occurs in relation to adherence. It can be used to encourage patient persistence with treatment by TCM practitioners and potentially other health professionals.

Communications Phenomenon of Traditional Chinese Medicine in Beijing and Jakarta (Case Study: Tong Ren Tang and Tong Fang Clinic)

The purpose of this study is to capture the phenomenon of communications that happened in the context of Traditional Chinese Medicine (TCM) for Indonesian people; encompassing interpersonal communication, group communication and mass communication. The research method used was Schutz’s phenomenology which is based on the search of the meaning of the behavior (action). Tracking data is conducted through direct and indirect observation at two Traditional Chinese Medicine clinics in Beijing and Jakarta. Informants consisted of the therapists (TCM physicians), patients and the government in the health field. In this study, the actions are the behavior of the actors constructed in TCM, which is measured through therapists and the actions of TCM patients in Beijing and Jakarta. The results shows that appropriate communication, supported by accurate evidence will facilitate and perpetuate the acceptance of TCM for Indonesians to go to Beijing or Jakarta. Bombardment of mass communication of TCM has increased the awareness for the presence of TCM in Jakarta, but also became a boomerang for TCM image overall.

Effects of Traditional Chinese Medicine on Chemotherapy-Induced Myelosuppression and Febrile Neutropenia in Breast Cancer Patients.

Title. Chemotherapy-induced myelosuppression lowers the quality of life in breast cancer patients and causes many complications. Traditional Chinese Medicine (TCM) is a widely used complementary and alternative medicine therapies. Objective. To study whether TCM can reduce the incidence of chemotherapy-induced leukopenia, neutropenia, and febrile neutropenia (FN) in breast cancer patients. Methods. The data were analyzed retrospectively between patients who received TCM treatment (group 1, n = 453) and patients who did not receive TCM treatment (group 2, n = 359). Significant risk factors associated with the occurrence of chemotherapy-induced leukopenia, neutropenia, and FN were identified using multivariate analysis. Propensity score-matched patients were analyzed to adjust for any baseline differences. Results. Group 1 patients had a significantly lower rate of chemotherapy-induced severe leukopenia, neutropenia, and FN, compared with group 2 (43% versus 71%, P < 0.0001, 72% versus 78%, P = 0.005, 6% versus 24%, P < 0.0001, resp.). Multivariate analysis revealed that chemotherapy regimens containing anthracyclines combined with paclitaxel or docetaxel were the most significant predictor. Subgroup analysis indicated that TCM treatment showed benefit in relieving chemotherapy-induced leukopenia and FN in most chemotherapy regimens. Conclusions. TCM treatment could lower the risk of severe chemotherapy-induced leukopenia, neutropenia, and FN in breast cancer patients.

Yang Deficiency Body Constitution Acts as a Predictor of Diabetic Retinopathy in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution Study.

Objective. Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus (DM), can cause severe visual impairment and blindness. To prevent the development of DR, identifying the associated risk factors for patient classification is critical. We conducted a cross-sectional study to determine whether body constitution (BC) is an independent predictor of DR. Method. 673 type 2 DM (T2DM) patients were recruited from a medical center, all received DR examination and body constitution questionnaire to assess BC. Other risk factors for DR were also recorded, including life style, history of diabetes, and blood pressure, etc. Multiple logistic regression analysis was conducted to calculate the odds ratios (ORs) for DR. Results. The prevalence of DR was significantly lower in Yang deficiency patients compared with non-Yang deficiency patients (24.69% versus 38.18% P = 0.02). After adjusting for other risk factors, we observed that patients exhibiting Yang deficiency BC were less likely to present with DR (OR = 0.531; 95% confidence interval = 0.312–0.903, P = 0.018). Conclusion. In addition to traditional risk factors, Yang deficiency BC might be an independent predictor of DR among T2DM patients and the results can be used as evidence for traditional Chinese medicine patient classification.

Advances in Patient Classification for Traditional Chinese Medicine: A Machine Learning Perspective.

As a complementary and alternative medicine in medical field, traditional Chinese medicine (TCM) has drawn great attention in the domestic field and overseas. In practice, TCM provides a quite distinct methodology to patient diagnosis and treatment compared to western medicine (WM). Syndrome (ZHENG or pattern) is differentiated by a set of symptoms and signs examined from an individual by four main diagnostic methods: inspection, auscultation and olfaction, interrogation, and palpation which reflects the pathological and physiological changes of disease occurrence and development. Patient classification is to divide patients into several classes based on different criteria. In this paper, from the machine learning perspective, a survey on patient classification issue will be summarized on three major aspects of TCM: sign classification, syndrome differentiation, and disease classification. With the consideration of different diagnostic data analyzed by different computational methods, we present the overview for four subfields of TCM diagnosis, respectively. For each subfield, we design a rectangular reference list with applications in the horizontal direction and machine learning algorithms in the longitudinal direction. According to the current development of objective TCM diagnosis for patient classification, a discussion of the research issues around machine learning techniques with applications to TCM diagnosis is given to facilitate the further research for TCM patient classification.

Favorable circulatory system outcomes as adjuvant traditional Chinese medicine (TCM) treatment for cerebrovascular diseases in Taiwan.

BackgroundThis study searches the National Health Insurance Research Database (NHIRD) used in a previous project, aiming for reconstructing possible cerebrovascular disease-related groups (DRG),and estimating the costs between cerebrovascular disease and related diseases.Methods and MaterialsWe conducted a nationwide retrospective cohort study in stroke inpatients, we examined the overall costs in 3 municipalities in Taiwan, by evaluating the possible costs of the expecting diagnosis related group (DRG) by using the international classification of diseases version-9 (ICD-9) system, and the overall analysis of the re-admission population that received traditional Chinese medicine (TCM) treatment and those who did not.ResultsThe trend demonstrated that the non-participant costs were consistent with the ICD-9 categories (430 to 437) because similarities existed between years 2006 to 2007. Among the TCM patients, a wide variation and additional costs were found compared to non-TCM patients during these 2 years. The average re-admission duration was significantly shorter for TCM patients, especially those initially diagnosed with ICD 434 during the first admission. In addition, TCM patients demonstrated more severe general symptoms, which incurred high conventional treatment costs, and could result in re-admission for numerous reasons. However, in Disease 7 of ICD-9 category, representing the circulatory system was most prevalent in non-TCM inpatients, which was the leading cause of re-admission.ConclusionWe concluded that favorable circulatory system outcomes were in adjuvant TCM treatment inpatients, there were less re-admission for circulatory system events and a two-third reduction of re-admission within ICD-9 code 430 to 437, compared to non-TCM ones. However, there were shorter re-admission duration other than circulatory system events by means of unfavorable baseline condition.

An Expert System for Supporting Traditional Chinese Medicine Diagnosis and Treatment

Abstract Portugal has recently become one the few European countries to fully acknowledge Traditional Chinese Medicine (TCM); this substantial paradigm shift calls for novel tools for TCM practitioners, students and patients alike. This paper describes an Expert System for supporting the TCM consultation process – both in terms of gathering and managing the patients’ personal and symptomatic data, and of obtaining accurate diagnoses and treatments under regulated and reviewed protocols. The proposed tool was designed and is being developed with the support of two TCM therapists, which act as experts and provide aid to the processes of building the knowledge base and the automatic diagnosis system. In terms of architecture, the current version of the framework includes a mobile client application for the Android platform, integrated with an online spreadsheet. A survey was conducted in order to assess some of the needs of the community of TCM practitioners, and allowed gathering information on their needs.