Traditional Chinese Medicine Practitioners Research Articles

Regulating Traditional Chinese Medicine Practitioners and Acupuncturists in Ontario, Canada

In 2006, the Ontario government passed the Traditional Chinese Medicine Act, which granted Traditional Chinese Medicine practitioners and Acupuncturists (TCM/A practitioners) self-regulatory status under the Regulated Health Professions Act, 1991 . The goal of the legislation was to create a new regulatory college that would set and enforce high standards of care and safety in order to enhance public protection and access to a range of traditional and alternative therapies. In April 2013, the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was officially launched. Several factors account for the government’s decision to delegate self-regulatory authority to TCM/A practitioners through the creation of a regulatory college. In particular, the government’s decision seems to have been influenced by lobbying of some practitioners, greater public acceptance of alternative medicines, patient safety concerns related to acupuncture cases in the media, and the precedence of self-regulatory status being granted to these practitioners in other provinces. The degree to which the legislation has achieved its goals is difficult to determine given the short period of time the regulatory college has existed. However, the fact that the college has developed standards of practice to guide TCM/A practitioners and has a process in place to address public complaints is an early indication of movement toward achieving the policy’s goals. Le gouvernement de l'Ontario a fait voter en 2006 la Loi sur les praticiens en medecine traditionnelle chinoise , qui accorde aux praticiens en medecine traditionnelle chinoise et aux acupuncteurs (praticiens en MTC/A) le statut de profession autonome dans le cadre la Loi sur les professions de la sante reglementees de 1991 . Le but de la Loi etait de creer un ordre professionnel capable d'etablir et appliquer des normes de qualite et de securite des soins, ceci dans le but d'ameliorer la protection du public et l'acces a un eventail de therapies traditionnelles et alternatives. L'Ordre des praticiens en medecine traditionnelle chinoise et des acupuncteurs de l'Ontario a ete officiellement cree en avril 2013. Cette decision du gouvernement de deleguer l'autorite de la regulation aux praticiens en MTC/A a travers un Ordre peut s'expliquer de plusieurs manieres. Entre autres, la decision du gouvernement semble avoir ete influencee par la pression exercee par certains groupes de praticiens, l'acceptation croissante par le public des medecines alternatives, des cas de mise en danger de la sante de patients d'acupuncteurs relates dans la presse, et l'autonomie professionnelle accordee a ces professions dans d'autres provinces. Il est encore trop tot pour evaluer le succes de cette Loi et de l'Ordre. Cependant, le fait que l'Ordre ait developpe des normes de pratiques pour guider les praticiens en MTC/A et ait mis en place un protocole pour traiter les reclamations du public est un signe de progres en direction de ces objectifs.

Consumers’ attitudes toward advertising by traditional Chinese medicine practitioners

This study investigated consumers’ attitudes toward advertising by traditional Chinese medicine (TCM) practitioners, and how attitudes varied among different demographic groups and user experiences in TCM. A survey using quota sampling was conducted. Altogether 1,039 adults aged 20 or above in Hong Kong filled in an online questionnaire in March 2014. Factor analysis found that attitudes toward TCM advertising consisted of four underlying dimensions: information value of TCM advertising; benefits of TCM advertising; confidence in financial aspects of TCM; and doubts about TCM advertising. Consumers’ attitudes toward TCM practitioners were in general favorable. Respondents appreciated information value of TCM advertising, but held some skepticism and worries about it. Respondents perceived strongly that advertising by medical professionals would lead to increase in the cost of services. Respondents with TCM consultation experience demonstrated a more positive attitude toward TCM advertising than respondents without TCM experience. Practical implications and limitations were discussed. (149 words)

Introduction of acupuncture for pain relief

This article is a general introduction to the use of acupuncture for pain relief. It discusses the internal and external causes of pain based on Traditional Chinese Medicine (TCM) theories, as well as the different clinical manifestations for each type of pain conditions. The article also discusses types of pain diagnosis per Traditional Chinese Medicine and offers guidance for acupuncture to improve treatment outcome. In conclusion, acupuncture provides a sustainable and natural way to relieve pain and address the underlying root cause of pain. Effective treatment outcome requires comprehensive knowledge base and skillful techniques from the TCM practitioners.

‘Big needles, small bodies’—the absence of acupuncture treatment for infants in contemporary Shanghai: a qualitative study

ObjectiveTo explore contemporary practices and clinical recommendations regarding the use of acupuncture for infants by Traditional Chinese Medicine (TCM) practitioners in Shanghai.DesignA qualitative study consisting of four field visits between...

Educational efficacy of objective structured clinical examination on clinical training of traditional Chinese medicine – A qualitative study

ObjectiveWe propose applying objective structured clinical examinations (OSCEs) and discuss the educational efficacy of such examinations regarding the clinical competence of traditional Chinese medicine (TCM) practitioners. DesignTCM OSCEs were implemented for evaluation and instruction from 2011 to 2013. Trainees received feedback from clinician-educators and standardized patients. Trainees' survey data were extracted from post-OSCE questionnaires and interviews to analyze TCM OSCEs. ResultsFive TCM OSCEs were administered, and the educational backgrounds of the 37 participants were analyzed. According to analysis of the questionnaires, all trainees agreed OSCEs were beneficial. In interviews, trainees expressed appreciation for the direct, real-time feedback during the OSCE and felt it closely resembled actual clinical work. However, the simulation models of OSCEs must be upgraded. ConclusionsOSCEs can be used in evaluating, teaching, and certifying TCM clinical competencies to improve the quality of TCM practices. The patient-centered training aspect of TCM OSCEs is particularly helpful for participants.

Integration of traditional Chinese medicine and Western medicine in a Chinese community health center

<h3>Objective</h3> Although the literature is abundant on traditional Chinese medicine (TCM) in the West, there is limited information on how TCM is integrated with Western medicine (WM). We describe how one Chinese Community Health Service (CHS) system located in Beijing integrates WM and TCM. <h3>Methods</h3> Our information is based on the authors’ observations, interviews with center TCM practitioners, and discussions with center administrators. <h3>Results</h3> We summarize our observations according to the following themes: selection of type of practitioner; frequent diagnoses of patients seen by TCM clinicians; types of TCM services provided; economic factors; challenges; and future directions. Patient age, nature of the problem, and cost may determine whether or not Chinese patients initially consult TCM or WM practitioners. Because of referral pathways between the WM and TCM practitioners, up to one-third of the patients receive integrated care. TCM physicians see more patients per day than do their WM counterparts; TCM physicians also earn higher salaries. Although there are clearly close collaborative relationships between the TCM and WM practitioners, a few TCM providers report that lack of respect between the two fields may be a barrier towards further integration. <h3>Conclusion</h3> Given governmental policies and the cost differentials between WM and TCM, the future for the integration of the two medical traditions within the CHS system appears to be favorable; however, issues of mutual respect and workforce issues may challenge successful integration. Our impressions are limited by the fact that we observed practices in only one community in one district of Beijing.

Effects of the combined extracts of Herba Epimedii and Fructus Ligustri Lucidi on bone mineral content and bone turnover in osteoporotic rats.

BackgroundThe decoction combination of Herba Epimedii and Fructus Ligustri Lucidi has been used to treat osteoporosis for almost 50 years by practitioners of traditional Chinese medicine. However, it is unclear what specific effects this combination of herbs has on the skeleton. The aim of this study was to assess the effects of the combined extracts from Herba Epimedii and Fructus Ligustri Lucidi on the bone turnover and bone mineral content in a rat model of osteoporosis induced by retinoic acid.MethodsFifty male Wistar rats were randomly assigned to the normal control group, osteoporosis model group, or treatment groups in which osteoporosis was induced and then the combined extracts of Herba Epimedii and Fructus Ligustri Lucidi were administered at 50, 100, or 200 mg/kg/day for 3 weeks via oral gavage. The rat osteoporosis model was induced by intragastric administration of 70 mg/kg/day of retinoic acid for 2 weeks. Bone turnover markers, bone biomechanical properties, and the calcium and phosphorus content of the right tibia and serum were measured.ResultsThe retinoic acid administration decreased the bone mass and the contents of calcium and phosphorus in the bone mineral, weakened the biomechanical properties, and increased bone turnover by stimulating bone resorption and collagen metabolism. Treatment with the combined extracts of Herba Epimedii and Fructus Ligustri Lucidi significantly mitigated the effects of osteoporosis on the rats by decreasing bone metabolism, improving the bone mineral content, and increasing the biomechanical properties.ConclusionsThe results of this study highlight the anti-osteoporosis effects of the combined extracts of Herba Epimedii and Fructus Ligustri Lucidi. These findings may contribute to the development of natural anti-osteoporosis herbal medicines.

Bibliometrics research of Traditional Chinese Medicine nursing research papers in China based on "China National Knowledge Infrastructure"

Objective By systematically analyse from 1950 to 2013 Chinese medicine nursing re-search situation, the paper aimed to give a comprehensive insight into the current situation of the development in Traditional Chinese Medicine (TCM) nursing, speed up the nursing literature resources development and utilization of traditional Chinese medicine and promote the comprehensive development of the discipline. Methods Using China National Knowledge Infrastructure (CNKI) as the data resource, the method of literature metrology was adopted to retrieve the valid papers, including published time distribution, regional distribution, the dispatch of productive organization, issuing system of institution, different number dis-tribution of authors, the author fund of cooperative research situation, the papers published periodical distribu-tion, the cited frequency content. Results A total of 3 569 effective papers in this study were selected, of which papers from 2010 to 2013 accounted for 46.70%.19 institutions had the highest paper production, dispatch agencies belonged to different systems, among which hospital and school accounted for a total amount of 96.30%, the core authors were 38 in the discipline research field, they published a total of 194 arti-cles, but the two literature metrology index analysis of degree and co-author rate showed that the authors lacked overall cooperation in the field of research. Conclusions Although the core authors had formed in the field of study, but through the analysis of parrot card law, the subject has not yet to reach maturity that the subject of the author's ideal distribution state. In scientific research activities for the future, researchers should strengthen cooperation, seek more high-level papers funded in order to enhance the development of TCM nursing level. Nurse practitioners of traditional Chinese medicine and related scientific research personnel should pay attention to related academic papers from areas prone to paper and paper productive organization. Relevant academic journals, especially the core journals in the field of research should increase Chinese medicine nursing papers from low level hospitals and basic medical service organization. At the same time we look forward to professional nursing journal of traditional Chinese medicine being founded. Key words: Medicine, Chinese Traditional; Nursing; Bibliometrics; Journal article

Chinese Herbal Medicines – Comparison of Doses Prescribed in Clinical Practice and those in China Pharmacopeia

Purpose : To compare the optimum doses of frequently used Chinese herbal medicines in clinical practice with stipulated doses in China Pharmacopoeia 2010, and assess the factors influencing choice of dose. Methods : A total of 303 practitioners of traditional Chinese Medicine (TCM) from 50 comprehensive TCM hospitals were investigated using a multi-stage randomized questionnaire. The content of the questionnaire included doses of frequently-used Chinese herbs, cognition of current doses in clinical practice, and doctors’ (practitioners’) opinions on dose levels. The median of Chinese herbal medicines’ dose prescribed by the participants was compared with the upper limit value (ULV) of stipulated doses in China Pharmacopoeia by assigned rank test. The centralized tendency of dose selection by TCM doctors was expressed as mean ± standard deviation. The top three factors influencing selection of dose were obtained using inclusion and exclusion criteria. Results : Among the selected Chinese herbs, the doses of 32 herbs exceeded ULV of the pharmacopoeia, accounting for 57.14 % (32/56). The top three factors influencing dose choice were variety and quality of the herbs, mode of preparation, and herbal combination. Furthermore, due to varying quality of the medicinal materials, method of preparation, and clinical experience, the doses among the 303 TCM doctors also varied considerably. Conclusion : There is a significant difference between the doses of herbal medicines prescribed by TCM doctors and the doses stipulated in China Pharmacopoeia. In most cases, the former doses are higher. Keywords : Chinese herbal medicines, China Pharmacopoeia, Dose selection, Multi-stage randomized questionnaire

Reducing drug-herb interaction risk with a computerized reminder system.

BackgroundTraditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions.MethodsHospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient.ResultsDuring the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL).ConclusionDrug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions.

Communication of professional literature amongst European Acupuncturists affiliated to the ETCMA (European Traditional Chinese Medicine Association): Explorative survey amongst Traditional Chinese Medicine practitioners in Europe

The primary aim of the survey was to explore the information needs and information seeking behavior amongst the ETCMA members concerning professional literature (scientific as well as practical background knowledge). A web-based survey comprising of 18 questions with a total of 25 items was carried out in 15 affiliated associations in 14 countries in June 2012. The survey consisted out of 4 parts: (1) Demographics, (2) Level of interest in and availability of professional literature, (3) Insight, needs and opinions on EBM (Evidence Based Medicine), and (4) Awareness of the science workshop at the TCM Rothenburg Congress. 2590 (25%) from 10,428 members completed the questionnaire, of which 58.8% was female. More than 50% of the respondents from eleven out of fourteen countries indicate an interest in more education on reading scientific literature. Case studies (range 3.19/4-3.86/4) are preferred compared to scientific (range 2.78/4-3.59/4) or philosophical knowledge (range 3.0/4-3.56/4). Exchange with colleagues (range 2.95/4-3.64/4) is preferred compared to deepening knowledge (range 2.57/4-3.05/4) in the theoretical spectrum. 61% has no knowledge of the EBM model and base clinical decisions on personal experience (range 3.47-3.82) and practical skills (range 3.47-3.74) compared to clinical practice guidelines (range 2.6-3.27). Due to heterogeneity in structure and size of the affiliated associations no strict conclusions can be made. We can conclude though that TCM practitioners rely mostly on practical knowledge and have less tendency toward more scientifically oriented models like the EBM model. We find this reflected in information needs as well as information seeking behavior patterns.

Current status and future prospects of acupuncture and traditional Chinese medicine in Canada.

Traditional Chinese medicine (TCM) and acupuncture has been gradually accepted by the mainstream society since the 1970s and has been rapidly expanding, accompanying the tide of Chinese immigration since the 1980s. Acupuncture legislation has been approved by the governments of 5 provinces in Canada between 1988 and 2014. After the acceptance of self-regulation, 5 corresponding colleges were established, one after another. The code of ethics and professional practice standard were developed by the Colleges. British Columbia (BC) became the first Canadian province to offer acupuncture treatments as a supplementary benefit for its Medical Services Plan premium assistance recipients beginning in 2008. The 5 colleges united to form the Canadian Alliance of Regulatory Bodies of Traditional Chinese Medicine Practitioners and Acupuncturists (CARBTCMPA) in the same year. The Entry-level Occupational Competencies for the Practice of TCM in Canada were developed by CARB-TCMPA in 2010. The Pan-Canadian registration examinations for acupuncturists, herbalists and TCM practitioners have been administered and scheduled since 2013. The Entry-level Occupational Competencies for Doctors of TCM were developed by College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia (CTCMA-BC) in 2014. It sketches the blueprint for future development of the TCM profession in Canada.

A Traditional Chinese Medicine Approach in Treating Depression by Promoting Liver Qi Circulation: A Western Medicine Perspective

Depression is a prevalent mental illness in developed countries. In Western medicine, experimental and clinical investigations have demonstrated that depression is associated with the dysregulation of neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic intervention. However, patients taking antidepressant drugs often experience serious side effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views depression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating depression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis stating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is involved in the processing of macronutrients into molecules to fuel energy metabolism in brain neurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain, thereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation, the failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production in neurons. Because neurotransmitter release and neurotropin transport are driven by ATP, the deficiency in release and transport processes resulting from insufficient ATP production could lead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression, the promotion of liver qi circulation by Chinese herbs might offer a promising prospect for the effective treatment of depression.

Do Consumers Prefer Wild, Farmed Bear Bile or Substitutes?

Bear bile, as a Traditional Chinese Medicine (TCM), has been used by TCM practitioners for millennia. Currently, there are arguments about bear farming as a tool for the conservation of wild bear. We designed questionnaires and surveyed citizens and college students in Beijing to elicit their perceptions and preferences toward wild or farmed bear bile and their substitutes. We found that most of students (57.37%) and citizens (38.99%) preferred substitutes rather than wild or farmed bear bile, due to “conservation of wild bears” and “cruelty in bile extraction from farmed bears”. Furthermore, under certain conditions, price and curative effects could be influential factors that alter purchase decisions of interviewees, and wild bear bile can be totally substituted by cheap and effective synthetic substitutes. So the success of a policy of “supply-side conservation” remains certain under the right conditions. The public of Beijing has recognized the importance of wildlife protection and their growing moral responsibilities for nonhuman animals might help reduce the threat to wild animals from medical needs.

Evidence-Based Patient Classification for Traditional Chinese Medicine.

Evidence-Based Patient Classification for Traditional Chinese Medicine.

ISMAC: An Intelligent System for Customized Clinical Case Management and Analysis.

Clinical cases are primary and vital evidence for Traditional Chinese Medicine (TCM) clinical research. A great deal of medical knowledge is hidden in the clinical cases of the highly experienced TCM practitioner. With a deep Chinese culture background and years of clinical experience, an experienced TCM specialist usually has his or her unique clinical pattern and diagnosis idea. Preserving huge clinical cases of experienced TCM practitioners as well as exploring the inherent knowledge is then an important but arduous task. The novel system ISMAC (Intelligent System for Management and Analysis of Clinical Cases in TCM) is designed and implemented for customized management and intelligent analysis of TCM clinical data. Customized templates with standard and expert-standard symptoms, diseases, syndromes, and Chinese Medince Formula (CMF) are constructed in ISMAC, according to the clinical diagnosis and treatment characteristic of each TCM specialist. With these templates, clinical cases are archived in order to maintain their original characteristics. Varying data analysis and mining methods, grouped as Basic Analysis, Association Rule, Feature Reduction, Cluster, Pattern Classification, and Pattern Prediction, are implemented in the system. With a flexible dataset retrieval mechanism, ISMAC is a powerful and convenient system for clinical case analysis and clinical knowledge discovery.

Advancing the evidence base and transforming cancer care through interprofessional collegiality: the society for integrative oncology.

The Society for Integrative Oncology (SIO) is pleased to support this seminal issue of JNCI Monographs devoted to integrative oncology and cancer survivorship. The SIO is an international professional society whose mission is to advance evidence-based, comprehensive integrative health care to improve the lives of people affected by cancer (www.integrativeonc.org). Since its founding in 2003 by pioneers in the field—Drs Barrie Cassileth, David Rosenthal, and Lorenzo Cohen—SIO has consistently encouraged rigorous scientific evaluation of both pre-clinical and clinical science, while advocating for the transformation of oncology care to integrate evidence-based complementary approaches. The vision of SIO is to have research inform the true integration of complementary modalities into oncology care, so that evidence-based complementary care is accessible and part of standard cancer care for all patients across the cancer continuum. As an interdisciplinary and interprofessional society, SIO is uniquely poised to lead the “bench to bedside” efforts in integrative cancer care. SIO members are comprised of a variety of professionals including, but not limited to, conventional cancer clinicians (ie, medical oncologists, radiation oncologists, and oncology nurses), family medicine providers, naturopathic doctors, traditional Chinese medicine practitioners, mind–body therapists, nutritionists, patient advocates, and basic scientists. This diverse membership facilitates true clinical integration of complementary modalities because such change requires breadth of expertise and different perspectives, to listen and learn from one another while challenging each other’s assumptions and existing paradigms. Annual SIO conferences, cosponsored with major academic centers, provide an unparalleled interprofessional opportunity for clinicians, researchers, and patient advocates to come together and advance integrative oncology research and best clinical practices. Health-care providers and patients alike are often searching for the next best treatment for cancer and ways to improve their quality of life in the midst of the challenges posed by disease or treatment side effects. Providers and patients wade through hundreds of articles and internet stories trying to find reliable information, which generally leaves them feeling overwhelmed and not sure what to believe. SIO’s commitment to research and knowledge translation has resulted in the development of three state-of-thescience papers and clinical guidelines. In 2009, the first article provided evidence-based clinical practice guidelines in complementary therapies with a focus on botanicals (1). Then the second article, published in 2013 in Chest, focused on integrative medicine in lung cancer (2). Finally, published in this monograph, SIO’s most recent guidelines focus on breast cancer survivorship and the use of integrative therapies in supportive care. This extensive research review and synthesis will be an invaluable resource to clinicians: to help them be well prepared to care for women with breast cancer, make appropriate referrals and recommendations, and answer breast cancer patients’ questions about the use of complementary therapies. In parallel, the guidelines will provide important information to women with breast cancer as they face decisions on whether and how to incorporate integrative therapies into their self-care.

Chinese medicine students’ views on electronic prescribing: A survey in Hong Kong

IntroductionElectronic prescribing (e-prescribing) can potentially improve the quality of patient care in traditional Chinese medicine (TCM) by facilitating clinical tasks. Published survey studies investigating e-prescribing use were mostly conducted in conventional medicine, but these findings cannot be entirely generalised to TCM practice. It is important, therefore, to investigate e-prescribing in the TCM context. PurposeTo investigate Chinese medicine students’ attitudes and perceptions of e-prescribing use in Hong Kong. MethodQuestionnaires were distributed to TCM students in three Hong Kong universities between January and May 2013. There were 259 participants in this study. Questionnaires were distributed and collected during lectures. The data was analysed using descriptive statistics. ResultsThe overall response rate was 89.3%. Only 21.2% of survey respondents had previously used an e-prescribing system. However, 86.5% of the respondents stated they want to use e-prescribing after they qualify as TCM practitioners. Patient care efficiency was rated as the most favourable outcome of e-prescription compared to handwritten prescriptions. The reliability of the e-prescribing system was rated as a major concern. ConclusionTCM students in Hong Kong were generally supportive of e-prescribing uptake. However, this study raised concerns and potential barriers to e-prescribing use. Factors that may facilitate e-prescribing uptake in TCM are also suggested. Further studies investigating TCM practitioners’ views will be required to identify further facilitators and barriers to the uptake of e-prescribing.

On the qi deficiency in traditional Chinese medicine

ObjectiveQi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners. Materials and methodsSteps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated. ResultsTwenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully. ConclusionThe results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD.

An integrated dietary/nutritional approach to ADHD.

Dietary and herbal interventions for attention-deficit/hyperactivity disorder (ADHD) have been proposed by practitioners of Western medicine and traditional Chinese medicine. Children who are suspected to have nutritional deficiencies, insufficiencies, and/or food allergies should be evaluated and, if the suspicion is confirmed, treated with supplementation or specific food elimination as part of standard care. Limited research exists on the efficacy and safety of dietary intervention as an adjunct to conventional medication; thus, improvement and side effects should be closely monitored.