Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (11): 1254-1262.doi: 10.3736/jcim20121109

• Original Clinical Research • Previous Articles     Next Articles

Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis

Dong-tao Li1(), Jian Wang1, Hong-yang Jiang2, Feng-lei Shi3, Fu-yu Li4, Ji-hong Liu5, Yong-mei Cheng5, Nan Yan5, Ai-hua Hu6, Mei-zeng Zhang7,Jie 8, Ling-bo Wei8, Rong-qin Jiang9   

  1. 1. Department of Comprehensive Traditional Chinese Medicine, Second Sanitarium Area, Qingdao First Sanatorium, Jinan Military Region, Qingdao 266071, Shandong Province, China
    2. Department of Orthopedics, Centre Hospital of Haiyang, Haiyang 265100, Shandong Province, China
    3. Second Department of Orthopedics, Qingdao Orthopaedic and Traumatology Hospital, Qingdao 266021,Shandong Province, China
    4. Department of Traditional Chinese Medicine, Qingdao First Sanatorium, Jinan Military Region, Qingdao 266071, Shandong Province, China
    5. Physical Examination Center, Qingdao First Sanatorium, Jinan Military Region, Qingdao 266071,Shandong Province, China
    6. Qingdao Social Welfare Institution, Qingdao 266071, Shandong Province, China
    7. Department of Neurology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266071, Shandong Province, China
    8. Department of Chinese Traditional Cardiology, Qingdao HaiCi Medical Group, Qingdao 266033, Shandong Province, China
    9. Department of Medical Services, Qingdao Integrated Traditional Chinese and Western Medicine Hospital, Qingdao 266002, Shandong Province, China
  • Received:2012-06-22 Accepted:2012-07-15 Online:2012-11-20 Published:2018-11-15

Objective: To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.

Methods: Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature.The symptoms and sighs were quantitatively classified into three, two or one category according to a 100-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then “Hall for Workshop of Metasynthetic Engineering” expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire.

Results: Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire (1 760 cases), and 1 545 of them were filled in completely. Experts’ opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%.

Conclusion: The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.

Key words: osteoporosis, TCM science, symptom complex, clinical trials

Table 1

Optimizing matrix of qi deficiency syndrome"

Symptom X2-1 X2-2 X2-3 X2-4 X2-5
X2-1 1 1 4 4 7
X2-2 1 1 1 4 4
X2-3 1/4 1 1 1 4
X2-4 1/4 1/4 1 1 1
X2-5 1/7 1/4 1/4 1 1
[1] Wu JJ, Wen LP, Wu YG, Shen Q, Han Y. Effects of Xianling Gubao Capsules for the treatment of bone loss induced by glucocorticoid. Zhongguo Gu Shang. 2009 ; 22(3):193-195. Chinese with abstract in English.
doi: doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
吴剑静, 温利平, 吴云刚, 沈权, 韩艳 . 仙灵骨葆胶嚢治疗糖皮质激素性骨质疏松症的临床疗效观察.中国骨伤. 2009; 22(3):193-195.
doi: doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
[2] Zhou M, Li GW, Wang X, Zheng YX, Xu Y, Shi Y, Shi YY, Shi GT, Zhao YF. Randomized controlled clinical trial for effect of Migu Capsule on bone mineral density of primary osteoporotic patients. Zhongguo Xin Yao Yu Lin Chuang Za Zhi. 2009; 28(7) : 509-512. Chinese with abstract in English.
周敏, 李国文, 王翔, 郑昱新, 徐宇, 石瑛, 石印玉, 石关桐, 赵咏芳 . 密骨胶嚢延缓原发性骨质疏松症病人骨量丢失的随机对照研究.中国新药与临床杂志. 2009; 28(7) : 509-512.
[3] Li DT, Li FY, Wang J, Liu JH, Yan N, Cheng YM, Hu AH, Jiang HY, Shi FL, Zhang MZ, Li J, Wei LB, Jiang RQ. A study of diagnostic criteria for traditional Chinese medicine syndromes in osteoporosis. J Chin Integr Med. 2011; 9(12):1326-1332. Chinese with abstract inEnglish.
doi: 10.3736/jcim20111208
李东涛, 李富玉, 王剑, 刘继红, 燕南, 程咏梅, 胡爱华, 姜洪洋, 史风雷, 张美增, 李洁, 魏陵博, 姜荣钦 . 骨质疏松症常见中医证候诊断规范研究.中西医结合学报. 2011; 9(12):1326-1332.
doi: 10.3736/jcim20111208
[4] Li DT, Ling CQ, Zhu DZ, Yu CQ, Chen Z, Zhai XF, Shen J, Zhang BH, Zhang JF, Lang QB. Study on the quantitative evaluation on the degree of TCM basic syndromes often encountered in patients with primary liver cancer. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007; 27(7) : 602-605. Chinese with abstract inEnglish.
doi: 10.3321/j.issn:1003-5370.2007.07.010
李东涛, 凌昌全, 朱德增, 俞超芹, 陈喆, 翟笑枫, 沈婕, 张百红, 张金峰, 朗庆波 . 原发性肝癌中医常见基本证候轻重程度量化评价研究. 中国中西医结合杂志. 2007; 27(7) : 602-605.
doi: 10.3321/j.issn:1003-5370.2007.07.010
[5] Li DT, Li J, Wang J, Li FY, Zhu JX, Zhang MZ, Li JY, Xu YL, Wei LB, Ji WY, Jiang RQ, Liu XF. Quantitative evaluation of the degrees of qualitative syndromes commonly encountered in patients with coronary heart disease. J Chin Integr Med. 2010; 8(8):750-756. Chinese with abstract inEnglish.
李东涛, 李洁, 王剑, 李富玉, 朱敬秀, 张美增, 李军艳, 许彦来, 魏陵博, 纪文岩, 姜荣钦, 刘学法 . 冠心病常见中医定性证候轻重程度量化评价.中西医结合学报. 2010; 8(8):750-756.
[6] Qian XS. A new discipline of science — the study of open complex giant system and its methodology. Cheng Shi Fa Zhan Yan Jiu. 2005; 12(5):1-8. Chinese with abstract inEnglish.
doi: 10.3969/j.issn.1006-3862.2005.05.001
钱学森 . 一个科学新领域——开放的复杂巨系统及其方法论.城市发展研究. 2005; 12(5):1-8.
doi: 10.3969/j.issn.1006-3862.2005.05.001
[7] Qian XS. Recognition on open complex giant system. Mo Shi Shi Bie Yu Ren Gong Zhi Neng. 1991 ; 4(1):1-4.Chinese with abstract inEnglish.
钱学森 . 再谈开放的复杂巨系统.模式识别与人工智能. 1991; 4(1):1-4.
[8] Sun ZQ, Xu YY. Medical statistics.3rd ed. Beijing: People’s Medical Publishing House. 2002: 386-390. Chinese.
孙振球, 徐勇勇 . 医学统计学.第3版.北京: 人民卫生出版社. 2002: 386-390.
[9] Group of Diagnosis Standard on Osteoporosis of Osteoporosis Committee of China Gerontological Society. Proposed standard of osteoporosis diagnosis on Chinese (the second draft) . . Zhongguo Gu Zhi Shu Song Za Zhi. 2000 ; 6(1):1-3Chinese.
中国老年学学会骨质疏松委员会骨质疏松诊断标准学科组. 中国人骨质疏松症建议诊断标准(第二稿).中国骨质疏松杂志. 2000; 6(1):1-3.
[10] Nickel JC . Effective office management of chronic prostatitis. Urol Clin North Am. 1998; 25(4) : 677-684.
doi: 10.1016/S0094-0143(05)70056-2 pmid: 10026774
[11] Guan JD, Wan X, Hu LS. Study on the methodology of quantification of symptoms of traditional Chinese medicine and assessment of therapeutic effects.. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002; 22(6) : 431Chinese.
官君达, 万霞, 胡立胜 . 中医症状量化及其疗效评定方法探讨.中国中西医结合杂志. 2002; 22(6):431.
[12] You S, Hu LS. Study on the methodology of the quantification of TCM symptoms and syndromes. Beijing Zhong Yi Yao Da Xue Xue Bao. 2002 ; 25(2):13-15. Chinese with abstract inEnglish.
由松, 胡立胜 . 中医症状及证候的量化方法探讨.北京中医药大学学报. 2002; 25(2):13-15.
[13] Dai RW, Cao LB. Research of hall for workshop of metasynthetic engineering. Guan Li Ke Xue Xue Bao. 2002 ; 5(3) : 10-16. Chinese with abstract inEnglish.
戴汝为, 操龙兵 . 综合集成研讨厅的研制.管理科学学报. 2002; 5(3) : 10-16.
[14] Cui X, Dai RW, Li YD. The emergence of collective wisdom in hall for workshop of metasynthetic engineering. Xi Tong Fang Zhen Xue Bao. 2003; 15(1):146-153. Chinese with abstract inEnglish.
doi: 10.3969/j.issn.1004-731X.2003.01.041
崔霞, 戴汝为, 李耀东 . 群体智慧在综合集成研讨厅体系中的涌现.系统仿真学报. 2003; 15(1):146-153.
doi: 10.3969/j.issn.1004-731X.2003.01.041
[15] Wang DL, Dai RW. Behavior criterion for expert group in hall for workshop of metasynthetic engineering. Guan Li Ke Xue Xue Bao. 2001 ; 4(2):1-6. Chinese with abstract in English.
王丹力, 戴汝为 . 综合集成研讨厅体系中专家群体行为的规范.管理科学学报. 2001; 4(2):1-6.
[16] Fang ZH, Geng JJ, Zhang YZ, Xia DS, Yin T, Liu JX, Ni YQ. Study on distrution and grouping regularity of TCM syndrome in 1 000 cases of senile osteoporosis. Zhongguo Zhong Yi Yao Xin Xi Za Zhi. 2007 ; 14(5):15-17. Chinese with abstract in English.
doi: 10.3969/j.issn.1005-5304.2007.05.007
方朝晖, 耿家金, 张有志, 夏东胜, 殷韬, 刘建新, 倪英群 . 1 000例老年性骨质疏松症证候分布与组合规律研究.中国中医药信息杂志. 2007; 14(5):15-17.
doi: 10.3969/j.issn.1005-5304.2007.05.007
[17] TangJM, Wu ZL, Peng LX, Wu SZ, Hong XQ. Study on syndrome development rule of primary osteoporosis and its correlation with sex hormone and bone mineral density change.. Hunan Zhong Yi Za Zhi. 2008; 24(6):24-26Chinese.
唐建明, 吴兆黎, 彭玲湘, 伍树芝, 洪秀琴 . 原发性骨质疏松症证候演变规律及其与性激素、骨密度变化关系的研究.湖南中医杂志. 2008; 24(6):24-26.
[18] Xie YM, Zhu YY, Ge JR, Piao HY, Yu J, Wang HM, Chen WH, Xing MR. Study on the TCM general syndrome of osteoporosis based on the clinical epidemiologicical investigation. Shi Jie Ke Xue Ji Shu Zhong Yi Yao Xian Dai Hua. 2007 ; 9(2) : 38-44. Chinese with abstract inEnglish.
谢雁鸣, 朱芸茵, 葛继荣, 朴海垠, 于嘉, 王和鸣, 陈卫衡, 刑美荣 . 基于临床流行病学调查的原发性骨质疏松症中医基本证候研究.世界科学技术中医药现代化. 2007; 9(2) : 38-44.
[19] Sheng T, Yang HM, Tian JZ, Han LB. Correlation between syndrome characteristics of senile bone loss and bone mineral density. Beijing Zhong Yi Yao Da Xue Xue Bao. 2006; 13(5):7-9. Chinese with abstract inEnglish.
盛彤, 杨惠民, 田金洲, 韩丽蓓 . 老年性骨量减少的证候特征及其与骨密度的相关性研究.北京中医药大学学报. 2006; 13(5):7-9.
[20] Li DT. Principles of syndromes of traditional Chinese medicine. . Sichuan Zhong Yi. 2010 ; 28(12):24-26Chinese.
李东涛 . 论证候原理.四川中医. 2010; 28(12):24-26.
[21] Yi CS, Liu XQ. Clinical observation of kidney-tonifying drugs for the treatment of primary osteoporosis.. Hunan Zhong Yi Xue Yuan Xue Bao. 2003; 23(2): 36-37Chinese.
doi: 10.3969/j.issn.1674-070X.2003.02.015
易成生, 刘向前 . 补肾方药治疗原发性骨质疏松症临床观察.湖南中医学院学报. 2003; 23(2):36-37.
doi: 10.3969/j.issn.1674-070X.2003.02.015
[22] Wang HM, Ge JR, Tian JZ, Peng SL, Shen L, Wu YN. Clinical trials of bone-strengthen capsule in treating primary osteoporosis. . Zhong Yao Xin Yao Yu Lin Chuang Yao Li. 2004; 15(4):284-287Chinese.
王和鸣, 葛继荣, 田金洲, 彭淑莲, 沈霖, 吴育宁 . 强骨胶嚢治疗原发性骨质疏松症临床试验.中药新药与临床药理. 2004; 15(4):284-287.
[23] Zhang ZB, Wang YY. Research on TCM syndrome nomenclature and classification:review and hypothesis. Beijing Zhong Yi Yao Da Xue Xue Bao. 2003 ; 26(2):1-5.Chinese with abstract inEnglish.
张志斌, 王永炎 . 证候名称及分类研究的回顾与假设的提出.北京中医药大学学报. 2003; 26(2):1-5.
[1] Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[2] Syed Nasir Abbas Bukhari, Fahad Hussain, Hnin Ei Thu, Zahid Hussain. Synergistic effects of combined therapy of curcumin and Fructus Ligustri Lucidi for treatment of osteoporosis: cellular and molecular evidence of enhanced bone formation. Journal of Integrative Medicine, 2019, 17(1): 38-45.
[3] Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[4] Subhranil Saha​, Munmun Koley​, Subhasish Ganguly​, Prasanta Rath​, Pulak Roy Chowdhury, Seikh Intaj Hossain. Developing the criteria for evaluating quality of individualization in homeopathic clinical trialreporting: A preliminary study. Journal of Integrative Medicine, 2014, 12(1): 13-19.
[5] Lu Liu, Ying Gao. Study on the correlation between traditional Chinese medicine syndrome and short-term prognosis of ischemic stroke using logistic regression model and repeated-measures analysis of variance. Journal of Chinese Integrative Medicine, 2012, 10(9): 983-990.
[6] Ying-fei Bi , Jing-yuan Mao , Xian-liang Wang , Ya-zhu Hou , Yi-zhu Lu , Shan Bin Soh , Bo-li Zhang. Clinical epidemiology survey of the traditional Chinese medicine etiology and syndrome differentiation of coronary artery disease: Study protocol of a multicenter trial. Journal of Chinese Integrative Medicine, 2012, 10(6): 619-627.
[7] Christoph A. Doenitz, Ana Anjos, Thomas Efferth , Tobias Greten, Henry J. Greten. Can heat and cold be parameterized? Clinical data of a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(5): 532-537.
[8] Yu Zhao, Jing-hua Peng , Xue-mei Li , Qi-lin Fu, Tuan Cui , Qi Li, Ya-jun Tang , Qin Feng , Hua Zhang , Hua Zhou , Yi-yang Hu. Diagnostic value of clinical indices in syndrome differentiation of chronic hepatitis B: an exploration based on receiver operating characteristic curves and stepwise discriminant analysis. Journal of Chinese Integrative Medicine, 2012, 10(12): 1382-1387.
[9] Gui-lin Ouyang, Xiao-hui Feng, Lian-bo Xiao, Zheng Huang, Qing Xia, Da-peng Han, Fei Zhu . Effects of Chinese herbal medicine Qianggu Capsule on patients with rheumatoid arthritis-induced osteoporosis: a report of 82 cases. Journal of Chinese Integrative Medicine, 2012, 10(12): 1394-1399.
[10] Lei Liu, Yuan-hui Guo , Hai-liang Xin , Yan Nie , Ting Han, Lu-ping Qin , Oiao-yan Zhang. Antiosteoporotic effects of benzylbenzoate glucosides from Curculigo orchioides in ovariectomized rats. Journal of Chinese Integrative Medicine, 2012, 10(12): 1419-1426.
[11] Xiang-ying Mao , Qin Bian , Zi-yin Shen. Analysis of the osteogenetic effects exerted on mesenchymal stem cell strain C3H10T1/2 by icariin via MAPK signaling pathway in vitro. Journal of Chinese Integrative Medicine, 2012, 10(11): 1272-1278.
[12] Ping Wang , Xu-dong Tang , Bao-yan Liu , Ming-jie Zi . Development of a patient-reported outcome instrument for chronic gastrointestinal diseases: Item selection. Journal of Chinese Integrative Medicine, 2012, 10(10): 1092-1098.
[13] Gui-xiang Chu, Qing-guang Chen, Jia-tuo Xu , Bo Yu , Min Zhang , Long-tao Cui , Hong-jin Wu , Zhao-fu Fei. Analysis on pulse diagram characteristics of subjects with subhealth state. Journal of Chinese Integrative Medicine, 2012, 10(10): 1099-1105.
[14] Xing-jiang Xiong, Hai-xia Li . Experience on clinical application of Chinese herbal medicine Yi Guan Jian decoction. Journal of Chinese Integrative Medicine, 2011, 9(8): 920-923.
[15] Ji Sun, Sheng-liang Zhu, Shu-ying Ma, Xiao-su Wang, Jing Kong. Clinical characteristics of patients with reflux esophagitis exhibiting gallbladder heat attacking the stomach or stagnant heat of the liver and stomach syndrome. Journal of Chinese Integrative Medicine, 2011, 9(7): 732-736.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)". Journal of Chinese Integrative Medicine, 2008, 6(1): 15-21
[4] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[5] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[6] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[7] Yi-ting He, Qing-lin Zha, Jian-ping Yu, Yong Tan, Cheng Lu, Ai-ping Lv. Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 32-36
[8] Jun Cai, Hua Wang, Sheng Zhou, Bin Wu, Hua-rong Song, Zheng-rong Xuan. Effect of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation: A randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(1): 37-40
[9] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[10] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50