Traditional Chinese Medicine
The technique of genomics and proteomics is one of the fastest developments with the farest-reaching consequences in the high and new biotechnology in the world of today. It can be used to screen the target molecules of the action of traditional Chinese medicines, to identify the new effective components from traditional Chinese medicines,and to explore the mechanisms of the effects of traditional Chinese medicines. It meets the shortcomings of the conventional methodology being applied in the current studies of traditional Chinese medicine. Application of the theories and technique of genomics and proteomics in the study of traditional Chinese medicine would be of great significance for opening new research field of traditional Chinese medicine, for facilitating the integration of traditional Chinese medicine and modern biological science and technology, and for promoting the internationalization of traditional Chinese medicine.
The article analyzed the contemporary study of pattern recognition of tongue images in traditional Chinese medicine by computer technology from its key sectors. It regards that the methods of orthogonal design and evaluation of image quality should be introduced to get a high-quality and practicable condition. In the field of tongue image segmentation, multiple methods used together are expected to improve the effect of segmentation. A scientific and canonical standard of tongue diagnosis based on comprehensive experts' experience with Delphi evaluation method and multi-center experts diagnosis on internet are also very essential. The study of pattern recognition on tongue image is still concentrated on the color. Further study should be extended to achieve quantification. And a comprehensive diagnosis on pattern recognition of tongue image is the aim that should be focused on later.
Evidence-based medicine (EBM) has drawn the attention of the medical community around the world and is rapidly becoming the standard in medical research. EBM requires both rigorous clinical trial research design, including adequate randomization and appropriate control, and accurate and thorough reporting of the findings of trials. Despite China's active research program, the majority of traditional Chinese medicine (TCM) clinical research in the Chinese literature fails to meet world standards of clinical research reporting, largely due to insufficient and inadequate reporting. Because of rising world demand for information on TCM research, enhancing the quality of research reporting in Chinese journals is imperative. Quality of reporting is important in all aspects of a manuscript, including the introduction/background, materials and methods, results, and discussion/conclusion sections. TCM journal editors, who serve as gatekeepers of quality, must encourage higher quality clinical research reporting by setting and upholding publication standards.
The strategy for treating liver fibrosis in chronic hepatitis patients includes dispelling the etiological factors, inhibiting the inflammatory reaction, decreasing the sedimentation of extracellular matrix, accelerating the degradation of extracellular matrix, improving the microcirculatory and metabolic disturbance, and ameliorating the complicating diseases, etc. Researchers should pay attention to the liver function indexes in chronic liver disease in evaluating the therapeutic effects of anti-fibrosis. Effective etiological treatment should be considered as the first step in treating liver fibrosis in chronic hepatitis patients, and inhibiting the inflammatory reaction is one of the most important tactics for suppressing the development of fibrosis and for decreasing the incidence rate of liver cancer in chronic hepatitis patients. Treatment based on syndrome differentiation, a dynamic therapy aimed at the holistic pathological state, can improve the pathological state of the disease. It is especially important to take the advantages of the integration of traditional Chinese and western medicine in the clinical diagnostic and therapeutic procedure for increasing the therapeutic effect of live fibrosis.
Adaptive response is a topic of general interest in medical research. Utilization of adaptive response has become a new treatment strategy for some diseases, the core of which is to stimulate the mechanisms of body internal protection, to improve the adaptive and anti-injury capability, and to maintain the homeostasis of the body. The existence of adaptive response indicates that the body internal protection can be induced and its key mechanism is the inducement of internal protective factors (internal protective proteins). In this article, some connections between adaptive response and the theory of traditional Chinese medicine (TCM) were discussed, which indicated that adaptive response is much beneficial for explaining some theories of TCM such as correspondence between human and nature, strengthening healthy qi to consolidate constitution, acupuncture theory, adaptogen herbs, and treating disease before its onset, etc. Thus the adaptive response is of great significance for explaining scientifically the connotative meaning of the theories of TCM and for promoting the integration of TCM and western medicine.
Great progress has been made in the study of fatty liver with integrated traditional Chinese and western medicine in aspects of diagnosis, treatment and experimental study, etc. Most researches were designed to utilize diagnostic or model replicating method of western medicine to observe the effects or investigate the action mechanism of compound recipe, single Chinese herb or effective ingredients of Chinese herbs on fatty liver. According to the pathological mechanism of traditional Chinese medicine (TCM), fatty liver is characterized by deficiency in nature and repletion in appearance, which involves three Zang viscera such as liver, spleen and kidney and manifests as spleen Qi deficiency, liver and kidney deficiency, phlegm and dampness heaping internally, and Qi stagnation and blood stasis. This facilitates us to use specific recipe or modified recipe to treat fatty liver from the points of integrated traditional Chinese and western medicine and combining syndrome differentiation with disease differentiation. With gratifying achievement, this kind of approach has been the mainstream of the research on fatty liver and many researchers have reached an agreement on this point domestically. Spleen Fortifying and Blood Invigorating Recipe (SFBVER in brief, invented by our institute) can significantly improve the B ultrasound outcome of the liver in patients with fatty liver, with significant difference in B ultrasound scoring between pre-and post-treatment. It can alleviate the patients' symptoms, improve or regain liver function, decrease waist/buttocks ratio and the content of triglyceride and cholesterol in blood. SFBVER is superior to Dongbao Gantai Recipe in general effective rate. Experimental study also reveals that SFBVER can alleviate CCl4 induced liver cell fatty degeneration and the inflammatory cell infiltration in rats, decrease the activities of ALT and AST, lower the content of triglyceride in liver, recover SOD activity in liver to normal level. The overall efficacy of SFBVER is superior to that of Dongbao Gantai Recipe. Further correlated study should be focused on inventing new preparation of traditional Chinese medicine and investigating its action mechanism with the guiding of the theory of TCM and referring to the latest discovery in fatty liver research in modern medicine.
The paper reviewed and analyzed the literature in the past five years about the function of the cells and mediums in the liver, and the influence and mechanism of traditional Chinese drug therapy on experimental liver fibrosis. It reveals that the traditional Chinese drug therapy treats experimental liver fibrosis through lots of mechanisms. The author gives also some suggestions on the further research into liver fibrosis.
The concepts of monomer medicine and the Chinese traditional medicine were introduced in this article. The different effects of a monomer drug between different types of syndromes of traditional Chinese medicine (TCM) were explained based on the author's clinical experience and related literature. The aim, significance and methods about the application of western medical drugs according to the theory of TCM were pointed out.And the feasibility of the application was analyzed.
To evaluate the effectiveness of traditional Chinese medicine (TCM) combined with western medicine on breast cancer after surgical resection.
Seventy-one patients with breast cancer received chemotherapy, radiotherapy, endocrine therapy and TCM following resection.
None of the patients died during the follow-up period.Fifty-seven patients were treated with TCM shortly after undergoing resection.Two recurrences (3.5%) and 6 metastases (10.5%) were observed in 8 patients, whose median disease free survival was 5.9 years.Fourteen patients didn't receive TCM until recurrence or metastasis emerged, with a median disease free survival of 3.5 years.There was significant difference between the two groups (P=0.033).
TCM combined with western medicine is efficient in preventing and delaying recurrence and metastasis.
In July 2002, the Women's Heath Initiative (WHI) clinical trial, designed to clarify the risks and benefits of combination hormone replacement therapy (HRT) to the postmenopausal women declared that interim safety review after an average follow-up of 5.2 years found that a combination of estrogen and progestin frequently prescribed to postmenopausal women in USA increased the risk of invasive breast cancer, heart disease, stroke, and pulmonary embolism while reduced bone fractures and colorectal cancer. The overall risks of HRT outweigh the benefits, which provides an opportunity for traditional Chinese medicine (TCM) going abroad. A variety of clinical and experimental evidences have showed that TCM exerts quite satisfactory effect on relieving postmenopausal symptoms with little adverse effect, hence a potential role to replace or to improve HRT or to reduce the side effect induced by HRT.
Syndromes constitute a core aspect in the study of Chinese medicine, and research on the concept of syndromes is important to the study of the process of modernization of traditional Chinese medicine. However, it is somewhat challenging to define a syndrome due to the complexity inherent in the subject, even with the assistance of the reductionism approach of modern medicine. Holistic and dynamic in nature and attaching much importance to functional changes, the newly emerging metabonomics is in many ways inline with the concepts of syndrome differentiation of pathological states in traditional Chinese medicine. Therefore, metabonomics has comparatively strong advantages in the very respect of revealing the natural laws of syndrome differentiation. By reviewing and analyzing the current research on the concept of syndromes and the application of metabonomic technology to exploring the essential core of syndrome differentiation, the authors illustrated the potential commonalities. This would also show the issues requiring attention between the study of syndromes and the metabonomic technology. In the meantime this study reflectd the core problems in detail and put forward suggestions with regard to reaching solutions.
OBJECTIVE: To observe the development of Chinese medicine syndromes of rats with type 2 diabetes and insulin resistance by detecting dynamic changes of laboratory parameters.METHODS: A total of 110 male Sprague-Dawley rats were randomly divided into control group (n=50) and model group (n=60) to observe the correlation between laboratory parameter changes and development of Chinese medicine syndromes. A rat model of type 2 diabetes and insulin resistance was established by feeding rats with high-calorie and high-fat diet together with peritoneal injection of streptozocin (30 mg/kg, once). At the end of 0, 6, 8, 10 and 12 weeks, 10 rats were randomly selected form each group and blood was taken from common carotid artery to detect contents of total cholesterol (TC), triacylglycerol (TAG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and leptinin serum, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) contents in plasma and whole blood and plasma viscosities.RESULTS: Compared with the control group, concentrations of TNF-α, IL-6, leptin and cAMP and ratio of cAMP/cGMP increased and content of cGMP decreased markedly from the 6th week to the 12th week. Concentrations of TC, TAG and LDL-C increased from the 8th week to the 12th week, while HDL-C decreased from the 10th week to the 12th week. Whole blood and plasma viscosity values under different shear rates increased significantly from the 10th week to the 12th week.CONCLUSION: Based on the understanding of markers which have close relationship with Chinese medicine syndromes of dual deficiency of qi and yin, turbid phlegm and blood stasis, combining with the dynamic changes of appearance behavior and laboratory parameters of this animal experiment, the authors speculate the development characteristics of Chinese medicine syndromes in rats with type 2 diabetes. The dynamic progress of Chinese medicine syndromes and pathology varies from dual deficiency of qi and yin to dual deficiency of qi and yin with turbid phlegm, and at last to the combination of dual deficiency of qi and yin, turbid phlegm and blood stasis.
Objective: To establish diagnostic criteria for common traditional Chinese medicine (TCM) syndromes in osteoporosis.Methods: 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.Results: 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%.Conclusion: The TCM syndrome diagnostic criteria for osteoporosis is generally consistent with TCM clinical practice, worthy of further popularization and application in clinical practice.
Objective: Due to the differences between Chinese and Western cultures, Chinese version of foreign research instruments may not be totally applicable for use in evaluating the therapeutic effect of traditional Chinese medicine (TCM). Great efforts have been made by Chinese researchers to develop scales for evaluation of the therapeutic effects of TCM. This study aims to understand the current situation of research in the development of evaluation instrument in TCM.
Methods: Database searches of Chinese Biomedical Literature Database, China Academic Journal Network Publishing Database and Chinese Scientific Journals Database were undertaken to identify published studies with the purpose of developing instruments in assessing the effectiveness of TCM, including papers regarding the construction of conceptual framework of instrument, item generation and selection and the evaluation of measurement properties.
Results: A total of 60 pieces of literature involving 36 instruments were included. The first article on the development of each of the instruments was published between 2005 and 2011 and the instruments were used in many kinds of medical conditions, including cardiocerebrovascular, respiratory, digestive and infectious diseases. The number of items ranged from 10 to 52. Of the 36 instruments, 13 (36.1%) defined the hypothesized concepts measured by the instrument, 30 (83.3%) reported the domains of the questionnaires before measurement property testing and all of them were multidomain. Of 32 studies regarding item selection and the instrument’s property evaluation, 14 (43.8%) articles reported the administration mode, 24 (75%) reported response option types, and 10 (31.5%) provided scoring algorithm for the scale, but none of these 32 studies specified the recall period. In 29 studies aiming at testing instrument’s measurement property, 28 articles tested the Cronbach’s α coefficient of the full scale and/or subscales, and retest reliability was also detected in 15 studies. Twenty-seven studies evaluated the construct validity by exploratory factor analysis and among them there were two studies applying confirmatory factor analysis. Content validity, responsiveness and feasibility of instruments were assessed in 11, 16 and 16 studies, respectively.
Conclusion: This study shows that in recent years many instruments have been developed in an attempt to evaluate the therapeutic effects of TCM, but some problems still exist in their practical implementation, including negligence in outlining the hypothesized concepts of the TCM instruments and in the reporting of instrument’s content validity such as administration mode, scoring and recall period. Some instrument attributes and testing methods were misunderstood and/or misused. Revision of instruments is rarely carried out, though the development of an instrument is an iterative process. Researchers should have a thorough understanding of the general procedure and steps before starting to develop an instrument.
Objective: To explore the analysis methods for composite traditional Chinese medicine (TCM) constitutions.
Methods: The epidemiological data of TCM constitutions were collected from 974 volunteers via a cross-sectional survey. The samples were classified into 9 constitution types according to the maximal standardized scores of imbalanced constitutions. The correlation matrix of 9 constitutions was computed. The standardized scores of 9 constitutions of all the volunteers were ranked respectively, and the composite status of every two constitutions was observed using cross tabulation. The constitution types of all the volunteers were transformed into ternary code of 9 digits, and the composite status of 3 or more than 3 kinds of constitution types was analyzed.
Results: According to the maximal standardized scores of imbalanced constitutions, of 974 volunteers, 227, 148, 218, 102, 31, 81, 44, 97 and 26 volunteers had balanced constitution, qi-deficiency constitution, yang-deficiency constitution, yin-deficiency constitution, phlegm-dampness constitution, heat-dampness constitution, blood stasis constitution, qi-stagnation constitution, and inherited special constitution, respectively. The standardized scores of balanced constitution were negatively correlated with those of imbalanced constitutions, while there was a positive correlation between the standardized scores of every two imbalanced constitutions. Among the 8 imbalanced constitutions, one kind of imbalanced constitutions was usually complicated with another kind of imbalanced constitutions. The number of qi-deficiency constitution complicated with yang-deficiency constitution, qi-deficiency constitution complicated with yin-deficiency constitution, and yin-deficiency constitution complicated with yang-deficiency constitution ranked the top three. The constitution types of 974 volunteers were transformed into a total of 465 ternary codes, showing a total of 465 kinds of constitution types; the simplex constitution, the approximately simplex constitution, and the composite constitution of two or more than two types were found in 259, 130, and 585 volunteers, respectively.
Conclusion: Cross tabulation can show the composite status of every two constitutions, while the ternary code can show the composite status of three or more than three constitutions.
Objective: To study the traditional Chinese medicine (TCM) syndrome distribution in patients with hepatitis B virus (HBV) infection in Qidong region of Jiangsu Province, China.
Methods: A cross-sectional survey was performed. Subjects from Qidong of Jiangsu Province of China were screened among the locally enrolled residents by detecting hepatitis B surface antigen (HBsAg) from May 2007 to May 2011 and were assigned to HBsAg-negative cohort or HBsAg-positive cohort. Then, the subjects were diagnosed according to alanine aminotransferase, alpha-fetoprotein and B ultrasound. The syndrome of the subjects was determined using a TCM questionnaire consisting of signs and symptoms.
Results: A total of 5 908 subjects were enrolled in this survey, among whom, 4 718 were diagnosed with HbsAg infection (positive result of HbsAg detection) and 1 147 were negative. 143 subjects were excluded for not receiving the blood examination. The final diagnoses of the subjects were non-HBV infection (n=1 128), HBV carrier (n=4 019), chronic hepatitis B (n=225), posthepatitic cirrhosis (n=263) or liver cancer (n=111). The TCM syndrome differentiation results showed that there were differences in syndrome distribution between HBV-infected and non-HBV-infected patients. The main syndromes of the HBV-infected patients were qi deficiency, qi stagnation, blood stasis and dampness heat, related to the Zang of liver and spleen. The distribution principles of TCM syndrome among patients of HBV carrier, chronic hepatitis B and cirrhosis were similar. Moreover, with the progression of the patients’ condition, the scores of syndromes increased, and the number of accompanying syndromes increased as well. The main syndromes of patients with liver cancer were blood stasis and excess heat, which was slightly different from that of the other HBV-infected patients.
Conclusion: The TCM syndrome distribution in patients of HBV infection in Qidong region of Jiangsu Province shows regularity. The disorder is mainly due to qi stagnation and blood stasis and is also related to deficiency of healthy qi, especially deficiency of spleen qi
Background: Coronary artery disease (CAD), a common disease with high incidence and mortality rate, has seriously threatened the health and life of the public. Traditional Chinese medicine (TCM) has an important role in the prevention and treatment of this disease. Through clinical epidemiological survey, a deeper understanding of TCM etiology and syndrome characteristics in CAD would further improve clinical efficacy in the treatment of this disease.
Methods/design: The preliminary clinical questionnaire for TCM etiology and syndrome differentiation in CAD was designed after literature reviews and analysis. Through a series of clinical pre-surveys, expert consultation and demonstration, the formal TCM clinical epidemiology questionnaire on the etiology and syndrome differentiation in CAD was finalized, after which, the study protocol, inclusive and exclusive criteria and related quality control measures were prepared. The multiregional clinical epidemiological survey with more than 5 000 participants with CAD will be carried out in 41 TCM hospitals of China for investigating the TCM etiology and syndrome differentiation of CAD.
Discussion: Multiregion large sample size clinical epidemiology survey on TCM etiology and syndrome differentiation in CAD will provide further evidence in preventing CAD and improving the standardization process of syndrome research.
Objective: To study the effect of Feiyanning Decoction (FYN), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) activated by tumor necrosis factor-α (TNF-α) in human lung adenocarcinoma epithelial cell line (A549).
Methods: A549 cells were incubated with rat serum containing FYN for 24 h. Gene expressions of iNOS and COX-2 were determined by quantitative real-time polymerase chain reaction and Western blot. The iNOS-dependent luciferase reporter was transfected for 24 h and the cells were treated with the reagents for 24 h, then the transcriptional activity of iNOS promoter was detected by luciferase assay. The production of NO was determined by diaminofluorescein-2.
Results: FYN significantly inhibited TNF-α-induced expression of iNOS and COX-2 compared with the control group in A549 cells (P<0.01, P<0.01). Also, FYN inhibited the transcriptional activity of the iNOS promoter and reduced NO production compared with the control group (P<0.01, P<0.01).
Conclusion: These results suggest that FYN inhibits iNOS and COX-2 activation induced by TNF-α, therefore, it is expected to develop a new strategy to treat lung cancer.
Traditional Chinese medicine (TCM) is regarded as an important treatment for gastric cancer patients, especially for those in advanced stage. To evaluate the effects of TCM treatment on gastric cancer patients, the authors performed a retrospective study to report the result of the integrated treatment of TCM with chemotherapy for stage IV non-surgical gastric cancer.
In this study, 182 patients with stage IV and non-surgical gastric cancer were retrospectively analyzed to evaluate the effects of TCM integrated with chemotherapy. Among the 182 cases, 88 cases received integrated therapy consisting of TCM and chemotherapy, while 94 cases received chemotherapy alone. The overall survival and Karnofsky performance status (KPS) score were measured as the main outcome.
The median overall survival of the integrated therapy group and chemotherapy group were 16.9 and 10.5 months, respectively. The 1-, 3- and 5-year survival rates of integrated therapy group vs. chemotherapy group were 70% vs. 32%, 18% vs. 4%, and 11% vs. 0%, respectively. There was a significant difference between the two groups (χ2 = 42.244, P < 0.001). After six-month treatment, KPS scores of the integrated therapy group and the chemotherapy group were 75.00 ± 14.78 and 60.64 ± 21.39, respectively (P < 0.001). The Cox regression analysis showed that TCM treatment is a protective factor for patients' overall survival.
This study demonstrated that TCM integrated with chemotherapy may prolong overall survival and improve survival rate and life quality of patients with stage IV non-surgical gastric cancer.
To treat patients with vascular mild cognitive impairment (VMCI) using traditional Chinese medicine (TCM), it is necessary to classify the patients into TCM syndrome types and to apply different treatments to different types. In this paper, we investigate how to properly carry out the classification for patients with VMCI aged 50 or above using a novel data-driven method known as latent tree analysis (LTA).
A cross-sectional survey on VMCI was carried out in several regions in Northern China between February 2008 and February 2012 which resulted in a data set that involves 803 patients and 93 symptoms. LTA was performed on the data to reveal symptom co-occurrence patterns, and the patients were partitioned into clusters in multiple ways based on the patterns. The patient clusters were matched up with syndrome types, and population statistics of the clusters are used to quantify the syndrome types and to establish classification rules.
Eight syndrome types are identified: Qi deficiency, Qi stagnation, Blood deficiency, Blood stasis, Phlegm-dampness, Fire-heat, Yang deficiency, and Yin deficiency. The prevalence and symptom occurrence characteristics of each syndrome type are determined. Quantitative classification rules are established for determining whether a patient belongs to each of the syndrome types.
A solution for the TCM syndrome classification problem for patients with VMCI and aged 50 or above is established based on the LTA of unlabeled symptom survey data. The results can be used as a reference in clinic practice to improve the quality of syndrome differentiation and to reduce diagnosis variances across physicians. They can also be used for patient selection in research projects aimed at finding biomarkers for the syndrome types and in randomized control trials aimed at determining the efficacy of TCM treatments of VMCI.
Polycystic ovary syndrome (PCOS) is an endocrine disease that affects gynecological health. Treatment of PCOS remains a big challenge for clinicians.
This meta-analysis was developed to compare the efficacy of co-treatment with traditional Chinese medicine (TCM) and letrozole against letrozole monotherapy in the treatment of PCOS.
Randomized controlled trials (RCTs) were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software (The Cochrane Collaboration, Copenhagen, Denmark).
We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources.
Data extraction and analysis
Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias.
Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups.
Available evidence showed that co-treatment with TCM and letrozole was more effective than letrozole monotherapy in the treatment of PCOS.
To analyze and compare the curriculum and delivery of a Chinese and Australian university-level Chinese medicine program.
A review of PubMed and the Chinese National Knowledge Infrastructure for relevant educational papers was undertaken. Online and paper documents available at the University of Technology Sydney (UTS) and the Chengdu University of Traditional Chinese Medicine (CDUTCM) were read and analyzed. In addition, in-depth interviews with academics from the two universities were conducted during 2014 to 2015.
The two Chinese medicine programs share the common goal of providing health services to the local community, but differ in some aspects when the curricula are compared. Areas such as student profile, curriculum structure, teaching approaches and education quality assurance were found to be different. The UTS program adopts a “flipped learning” approach with the use of educational technology aiming at improving learning outcomes. On the other hand, the CDUTCM has better clinical facilities and specialist physician resources.
A better understanding of the different curricula and approaches to Chinese medicine education will facilitate student learning and educational outcomes.
Pulse wave analysis (PWA) quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine.
This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension.Design, setting, participants and interventions This observational, cross-sectional study enrolled 45 patients (26 men, (55.2 ± 10.3) years, systolic blood pressure (155 ± 28) mmHg, diastolic blood pressure (93 ± 17) mmHg) for assessment of clinical and laboratorial data.
Main outcome measures
Primary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the ‘simultaneous pressing’ method for identification of factors such as strength (strong/weak), depth (superficial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system.
Significant multivariate main effects were observed for depth (λ=0.648, F5,29 =3.149, P=0.022, η2 =0.352), strength (λ=0.608, F5,29 =3.736, P=0.010, η2 =0.392), and speed (λ=0.535, F5,29 =5.302, P=0.002, η2 =0.465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s.
Associations were explained by LaPlace's law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.
The field of gene therapy has been increasingly studied in the last four decades, and its clinical application has become a reality in the last 15 years. Traditional Chinese medicine (TCM), an important component of complementary and alternative medicine, has evolved over thousands of years with its own unique system of theories, diagnostics and therapies. TCM is well-known for its various roles in preventing and treating infectious and chronic diseases, and its usage in other modern clinical practice. However, whether TCM can be applied alongside gene therapy is a topic that has not been systematically examined. Here we provide an overview of TCM theories in relation to gene therapy. We believe that TCM theories are congruent with some principles of gene therapy. TCM-derived drugs may also act as gene therapy vehicles, therapeutic genes, synergistic therapeutic treatments, and as co-administrated drugs to reduce side effects. We also discuss in this review some possible approaches to combine TCM and gene therapy.
The central nervous system (CNS) plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine (TCM) has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.
Progressive loss of retinal ganglion cells (RGCs) and their axons is the main pathogenesis of glaucoma. The cause of glaucoma is not fully understood, but the neurodegeneration of glaucoma involves many mechanisms such as oxidative stress, glutamate toxicity and ischemia/reperfusion insult. In order to target these mechanisms, multiple neuroprotective interventions have been investigated to prevent the death of RGCs. Of note are some tonic herbs from the traditional Chinese medicine (TCM) pharmacopeia that have shown neuroprotective effects in glaucoma. TCM differs from Western medicine in that TCM exhibits complicated bioactive components, triggering many signaling pathways and extensive actions on vital organs. Modern scientific approaches have demonstrated some of their underlying mechanisms. In this review, we used Lycium barbarum and Ginkgo biloba as examples to elaborate the characteristics of TCM and their potential applications in neuroprotection in glaucoma.
Chinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine (TCM) is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy.
We proposed the development of the SuiteTCM software, a collection of integrated computational models mainly derived from epidemiology and statistical sciences for computerization of Chinese medicine scientific research and clinical practice in all levels of prevention. The software includes components for data management (DataTCM), simulation of cases (SimTCM), analyses and validation of datasets (SciTCM), clinical examination and pattern differentiation (DiagTCM, TongueTCM, and PulseTCM), intervention selection (AcuTCM, HerbsTCM, and DietTCM), management of medical records (ProntTCM), epidemiologic investigation of sampled data (ResearchTCM), and medical education, training, and assessment (StudentTCM).
The SuiteTCM project is expected to contribute to the ongoing development of integrative medicine and the applicability of TCM in worldwide scientific research and health care. The SuiteTCM 1.0 runs on Windows XP or later and is freely available for download as an executable application.
Many clinical studies showed that the traditional Chinese medicine (TCM) syndromes in stroke have been dynamically changing since the onset of the disease. The changing of TCM syndromes can be attributed to multiple correlative factors such as age, sex, area distribution, underlying diseases, and constitutional factor. Data-driven methods involving multivariate statistical methods and descriptive approach have been used to analyze the regularity of dynamically changed TCM syndromes of stroke. However, expressing non-linear relationship between symptom or correlative factors and syndrome patterns by data-driven models is challenging. Model-driven methods involving artificial neural networks and Bayesian networks are new methods for studying the changes in TCM syndromes in patients with stroke. In this review, the authors summarized the studies of dynamically changed patterns of stroke syndromes based on data-driven methods and some clinical trials on TCM syndromes based on model-driven methods. Further studies are needed to improve the understanding of the dynamically changing regularity of TCM syndromes for stroke by using model-driven methods so as to develop appropriate and timely TCM treatments.
As the post-genome era is approaching, omics has become a hot topic in the research field of life sciences and is also widely used in traditional Chinese medicine (TCM) research. For discussing the correlation between syndromes and omics, the authors explored the application of genomics, proteomics and metabonomics in the study of syndrome classification from the macroscopic view, after a systematic and normative study of the literature. The authors drew the conclusion that research into the correlation between syndromes and omics has great clinical significance in terms of the scientific application and quantification of TCM treatment based on syndrome differentiation.
In this paper, the authors make an analysis of the historical literature during the Red Army period of the agrarian revolution war, dealing with the situation of traditional Chinese medicine in the Red Army. During that time the Red Army had created revolutionary medical hospitals, gathering herbal medicine, growing herbal plants and producing Chinese medicines. At the same time the Red Army paid great attention to enriching Chinese medicine, cultivating practitioners and treating and preventing diseases using traditional Chinese medicine. During the Red Army period there was an extreme lack of medical facilities; traditional Chinese medicine played an important role in ensuring the fighting capabilities of the Red Army units. Looking back at the Red Army period, the development of our tradition can be seen, which enables future development of traditional Chinese medicine, as well as integrated medicine.
Objective: To investigate the correlation between cognitive function and the Chinese medicine syndrome characteristics of vascular cognitive impairment (VCI).
Methods: A total of 774 subjects (age from 41 to 87 years old) from Beijing of China accepted neuropsychological assessments and differentiation of Chinese medicine syndromes. The mini-mental state examination (MMSE) and clinic dementia rating (CDR) were used to access the global cognitive function; the Hachinski ischemia scale (HIS) and the Hamilton depression scale (HAMD) were used for differential diagnosis; the ability of daily living (ADL) scale was used to assess the ability of daily living; the clock drawing test was used to access the executive function; the investigation of syndrome manifestations and the syndrome differentiation scale of vascular dementia (SDSVD) were used for diagnosis of syndrome manifestations. According to the diagnostic criteria of vascular cognitive impairment, subjects were subgrouped as normal cognition (NC) group and VCI group, and then the correlation between the cognitive functions and Chinese medicine syndromes was analyzed.
Results: The correlation between cognitive scales and Chinese medical syndrome: in the VCI group, the syndrome of phlegm turbid blocking upper orifices showed negative correlation with the scores of MMSE and CDT (r=–0.525, r=–0.321, P=0.000, P=0.001), and the ADL demonstrated positive correlation to the syndrome (r=0.424, P=0.000). The correlation between cognitive function and Chinese medical syndrome: the phlegm turbid blocking upper orifices was closely correlated with the total orientation, time orientation and place orientation (r=–0.451, r=–0.448, r=–0.392, P=0.001, P=0.000, P=0.004); instant word recall and delayed word recall were closely correlated with the syndrome of phlegm turbid blocking upper orifices (r=–0.355, r=–0.225, P=0.000, P=0.021); calculation/attention, language function and executive function had negative correlation to the syndrome of phlegm turbid blocking upper orifices (r=–0.379, r=–0.448, r=–0.321, P=0.000, P=0.000, P=0.013). The scores of orientation, calculation/attention, delayed word recall and language function in the patients with phlegm turbid blocking upper orifices were significantly lower than the patients with non-phlegm turbid blocking upper orifices (P<0.05).
Conclusion: The syndrome of phlegm turbid blocking upper orifices is significantly correlated to the scores of MMSE and ADL, indicating that the phlegm turbid blocking upper orifices is related to the cognitive function and ability of daily living in the VCI patients. Treatment of the phlegm is important in the cognitive impairment in VCI patients.