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ObjectiveTo explore the macroscopic medication pattern of traditional Chinese medicine （TCM） in treating esophageal cancer （EC） and provide medication references for the clinical application of TCM in EC treatment. MethodRelevant literature on TCM treatment of EC was retrieved from three major Chinese databases： China National Knowledge Infrastructure （CNKI）， Wanfang Data， and VIP. Information about Chinese herbal medicines was entered into Excel to establish a prescription database for EC. The data were standardized， summarized， and subjected to frequency analysis， association rules， and cluster analysis of medication in the prescriptions. Based on the TCM classification of EC syndromes， clinical indications corresponding to each syndrome were identified， and high-frequency drugs and drug pairs were analyzed correspondingly with syndromes. ResultA total of 136 prescriptions containing 240 Chinese herbal medicines were screened， with a cumulative frequency of 1 853 times. The top 5 frequently used Chinese herbal medicines were Glycyrrhizae Radix et Rhizoma， Poria， Atractylodis Macrocephalae Rhizoma， Astragali Radix， and Pinelliae Rhizoma. In terms of functions， the Chinese herbal medicines were mainly deficiency-tonifying， urination-promoting and dampness-draining， deficiency-tonifying， deficiency-tonifying， and phlegm-resolving and cough and dyspnea-relieving ones. The statistical analysis of flavor， property， and meridian tropism showed that Chinese herbal medicines were mainly bitter and sweet， warm， cold， and neutral， and acted on the spleen， lung， and stomach meridians. Association rule analysis yielded nine potential drug combinations， and cluster analysis of high-frequency drugs resulted in four combination categories. The four TCM syndromes for EC corresponded to respective clinical indications， treatment drugs， and drug pairs. ConclusionTonifying deficiency， reinforcing healthy Qi， descending adverse Qi， resolving phlegm， activating blood， and resolving stasis are the basic principles of TCM treatment for EC， which are supplemented by clearing heat and dissipating mass while focusing on regulating and smoothing the qi movement. The drug combinations obtained from high-frequency drug and association rule analysis provide references for different TCM syndrome treatments of EC， offering valuable insights for clinical medication.
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At present, new concepts, new technologies, and new methods are emerging in the field of medical research, breaking through the inherent thinking patterns and research models, and promoting the transformation of the research paradigm of traditional Chinese medicine(TCM). This paper gave a case study of clinical research in Danhong Injection in the treatment of chronic stable angina, and based on the background of the study, index evaluation model, experimental design method, blind implementation of placebo, data management system, and exploration of clinical efficacy mechanism of traditional Chinese medicine compounds under the framework of modular pharmacology, the scientific idea of "proving efficacy, conforming standard, and exploring mechanism" was used as the guideline to discuss the research model of reevaluation of the effectiveness of post-marketing TCM varieties. This paper drew a target network map of Danhong Injection in the treatment of chronic stable angina for the first time, which was composed of targeted functional modules. By combining evidence-based clinical research with modular pharmacology framework, changes in the pharmacolo-gical mechanism were finally associated with changes in clinical efficacy, and the advantages of phenotypic correlation of efficacy were explored. This study is expected to provide references for the post-marketing effectiveness evaluation and new ideas for the phenotypic pharmacological mechanism study of multi-target TCM compounds and precise treatment, thereby promoting the innovative development of TCM.
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Humans , Medicine, Chinese Traditional , Angina, Stable/drug therapy , Drugs, Chinese Herbal/therapeutic use , Treatment OutcomeABSTRACT
Objective:To investigate the application effect of problem-based learning (PBL) combined with case-based learning (CBL) in standardized training of traditional Chinese medicine (TCM) clinical pharmacists.Methods:A total of 40 TCM clinical pharmacists who received the standardized training of TCM clinical pharmacy in Chongqing Traditional Chinese Medicine Hospital from August 2020 to July 2021 were enrolled as subjects and were randomly divided into research group (PBL combined with CBL) and control group (traditional teaching). The two groups were compared in terms of theoretical knowledge, practical skills, and the degree of satisfaction with training. SPSS 23.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the research group had significantly higher scores of theoretical knowledge [(49.45±5.52) vs. (40.54±5.65), P<0.05] and practical skills [(48.65±5.23) vs. (41.53±4.41), P<0.05]. As for the degree of satisfaction with training, the questionnaire survey showed that compared with the control group, the research group had significantly better results in strong ability to analyze and solve clinical issues, strong learning initiative and enthusiasm, teachers' willingness to interact with students, teaching and learning benefiting each other, and satisfaction with this assessment method ( P<0.05). Conclusion:The combined teaching model of PBL and CBL can help to improve the teaching quality of standardized training for TCM clinical pharmacists and cultivate the good learning habits, independent thinking ability, and clinical thinking ability of pharmacists, and therefore, it is beneficial to cultivating high-quality TCM clinical pharmacists.
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Objective@# To compare the efficacy and safety of combining diosmin with Jiuhua hemorrhoid suppository versus diosmin alone for the treatment of hemorrhoid hemorrhage.@*Methods@#The Jiuhua hemorrhoid suppository study was conducted in 10 medical centers across China from April 1, 2019 to June 30, 2020. Patients with hemorrhoid bleeding were randomized in a ratio of 1 : 1 to either receive Jiuhua hemorrhoid suppository and diosmin tablets (the study group) or diosmin tablets alone (the control group). The suppository was used once a day after defecation or at bedtime after rinsing the anus with warm water. Diosmin tablets were administered only once a day (0.9 g). The primary endpoint of the study was the assessment of hemorrhoid bleeding relief 7 ± 2 days after treatment, classified as “very effective” “effective” and “ineffective”. The secondary endpoint included the evaluation of pain alleviation using the visual analogue scale (VAS, with scores ranging from 0 to 10) and edema (with scores ranging from 0 to 3). The safety of the two treatment regimens was evaluated 14 ± 2 days after drug administration.@*Results@#The full analysis set (FAS) comprised 107 participants in the study group and 111 in the control group, while the per-protocol set (PPS) included 106 participants in the study group and 111 in the control group. In terms of hemorrhoid bleeding, the proportion of very effective and effective cases in the study group were significantly higher than that in the control group [106 (99.06%) vs. 91 (81.98%), P < 0.0001] in the FAS, and the PPS results [105 (99.06%) vs. 91 (81.98%), P < 0.0001] were comparable to the FAS results. The pain VAS scores at day 7 after treatment were comparable between the two groups (0.80 ± 1.17 vs. 0.80 ± 1.20, P = 0.2177). The majority of the participants in both groups had an edema score of 0 at day 7 after treatment [96 (89.72%) vs. 99 (91.67%), P = 0.370 5]. Adverse events (AEs) occurred in 9 patients (8.4%) in the study group and 3 patients (2.7%) in the control group. In addition, 5 AEs in the study group and 1 AE in the control group were possibly in association with the study drug.@*Conclusion@#Compared with the administration of diosmin oral tablets alone, the addition of Jiuhua hemorrhoid suppository to the tablets demonstrates enhanced efficacy in addressing hemorrhoid bleeding, with satisfactory patient adherence and acceptable safety.
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Topic selection of traditional Chinese medicine (including integrative medicine) graduate students were different from other topics, has its own characteristics and methods. This article summarizes the range of topics and research methods of TCM graduate students in the research of TCM clinical literatures. The study found that TCM clinical literature research can be divided into the disease nomenclature, theoretical origin and connotation research, literature research based on the characteristics of different TCM academic schools, understanding of disease and zheng-treatment law of traditional Chinese medicine academic dynastic history, ancient famous medical academic ideas and clinical evidence Empirical research, based on a series of ancient traditional Chinese medical books researches, traditional Chinese medical case studies. Each aspect has its own characteristics and methodological choices based on commonalities research. The research process is also different, but it is important to choose a good point for different TCM clinical problems or diseases, and to formulate a research content to adapt to the norms of research programs to ensure that the purpose of a clear, standardized processes, and make the results reliable.
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Objective To evaluate the clinical applicability of Traditional Chinese Medicine (TCM) Clinical Practice Guidelines of Perirectal Abscess (ZYYXH/T322-341-2012); To provide the evidences for the revision. Methods Questionnaire survey was performed in this study. 50 surgeons in department of anorectal surgery from different hospitals were asked to fill in a questionnaire designed by State Administration of TCM, and the investigated data were statistically analyzed in respect to the general information, quality, and application status. Results 76% of investigated surgeons were familiar with the guideline, but only 48% of them have used this guideline. In statistical agreement rates of those items to reflect the quality of the guideline, except for rates of "syndrome classification is reasonable" item was 76%, and "recuperating reserve is reasonable" item was 0%, which were referred as not qualified, the rates of the other items were all more than 90%. In statistical application rates of items to reflect the application of the guide, except for the rate of "comparing with expert experiences", the rates of the other items were all more than 90%. Conclusion The general applicability of TCM Clinical Practice Guidelines of Perirectal Abscess is relatively well. The next revised work should uptake not only the experiences of prominent TCM doctors, but also the therapeutic programs of distinctive hospitals and all kinds of research achievements.
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Objective To evaluate the clinical applicability of Traditional Chinese Medicine (TCM) Clinical Practice Guidelines of Perirectal Abscess (ZYYXH/T322-341-2012); To provide the evidences for the revision. Methods Questionnaire survey was performed in this study. 50 surgeons in department of anorectal surgery from different hospitals were asked to fill in a questionnaire designed by State Administration of TCM, and the investigated data were statistically analyzed in respect to the general information, quality, and application status. Results 76% of investigated surgeons were familiar with the guideline, but only 48% of them have used this guideline. In statistical agreement rates of those items to reflect the quality of the guideline, except for rates of "syndrome classification is reasonable" item was 76%, and "recuperating reserve is reasonable" item was 0%, which were referred as not qualified, the rates of the other items were all more than 90%. In statistical application rates of items to reflect the application of the guide, except for the rate of "comparing with expert experiences", the rates of the other items were all more than 90%. Conclusion The general applicability of TCM Clinical Practice Guidelines of Perirectal Abscess is relatively well. The next revised work should uptake not only the experiences of prominent TCM doctors, but also the therapeutic programs of distinctive hospitals and all kinds of research achievements.
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Objective:To explore the effects of Chinese medicine clinical pharmacists participating in the formulation and imple-mentation of traditional Chinese medicine clinical pathway in orthopaedics department. Methods: Totally 60 cases of radius fracture patients were selected from 2009 to 2011 as the control group, and 54 cases of radius fracture patients were selected as the observation group in our hospital during 2015 and 2016. The observation group was instructed by both Chinese medicine clinical pharmacists and doctors;meanwhile, Chinese medicine clinical pharmacists were responsible for the entire pharmaceutical care. The clinical curative effect of the two groups, the rational use rate of traditional Chinese medicines, the average length of stay, the average cost of traditional Chinese medicines and the incidence of ADR between the groups were compared. The effect of Chinese medicine clinical pharmacists participating in the formulation and implementation of clinical pathway was evaluated. Results:After the formulation and implementa-tion of clinical pathway, the total effective rate was improved from 80. 0% to 92. 6%, the rational use rate of traditional Chinese medi-cines increased significantly from 60. 0% to 85. 2%, and the differences were statistically significant (P<0. 05). The average length of stay decreased significantly from (14.0 ±2.3) d to (11.0 ±3.1) d and the difference was statistically significant (P<0.05). Meanwhile, the average cost of traditional Chinese medicines decreased from (887. 07 ± 186. 44) yuan to (437. 14 ± 127. 32) yuan and the difference was statistically significant (P<0. 05). Moreover, the incidence of ADR decreased from 16. 7% to 11. 1%. Con-clusion:Chinese medicine clinical pharmacists should participate in the whole process of clinical pathway, which can play an important role in ensuring the implementation of clinical pathway and standardizing the rational drug use. It can significantly make the clinical medication safer,and more effective and economical. It can shorten the hospital stay and reduce the hospitalization costs as well.
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Objective To evaluate the effect for stroke(cerebral infarction)at acute stage intervened by traditional Chinese medicine(TCM) clinical pathway. Methods A retrospective analysis was carried out in the patients before and after intervention by TCM clinical pathway during the year of 2013-2016. The outcomes included the entrance rate,completion percentage,aberration rate,severity,hospitalization time,and hospitalization fee as well as functional prognosis 30 d after discharge. Results A total of 792 cases was included,241 cases admitted in the year of 2013, 191 in the year of 2014, 135 in the year of 2015, and 225 in the year of 2016. In the year of 2014-2016,the entrance rate,completion percentage,hospitalization time,hospitalization fee,critical case percentage,and gender constituent ratio were steadily(P > 0.05). Modified Rankin Scale(mRS)for short-term functional prognosis mRS 0 ~ 2 percentage and aberration rate in the year of 2016 were superior to those in the year of 2014 and 2015(P < 0.05). Functional improvement on discharge day 30 in the year of 2014-2016 was superior to that in the year of 2013(P < 0.05). The hospitalization time and hospitalization fee in the year of 2014-2016 were a liffle higher than those in the year of 2013(P < 0.05), showing no obvious increase. Conclusion The application of TCM clinical pathway can make the diagnosis and treatment procedure of stroke at acute stage standardized,enhance the therapeutic effect,achieve or even exceed the goal of manage scheme.
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This study was aimed to explore and summarize traditional Chinese medicine (TCM) syndrome differentiation of chronic bronchial asthma,in combination with characteristics of clinical TCM syndrome,clinical phenotype of asthma and the research of genomics in order to provide references.This study was conducted by the method of combining retrospective literature research and clinical epidemiological survey,designing and inducing the formation of chronic duration of bronchial asthma in TCM syndrome observation table,through literature research and analysis and pre-survey feedback information revision method.The four diagnostic data of 204 cases was collected and filled in the observation table.With the help of SPSS22 statistical analysis software,the database was established and the method of cluster analysis was applied to induce the basic TCM syndrome types of chronic bronchial asthma.The results showed that bronchial asthma chronic persistent period was divided into two basic syndromes,which were the cold-deficiency syndrome and heat-deficiency syndrome.It was concluded that the clinical phenotype of bronchial asthma chronic duration was explored for further research on the relationship between TCM syndrome differentiation of cold and heat as well as the modem medicine genomics to provide research data.
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After the methods for selection of syndrome concepts and establishment of relationship between syn-drome concepts in Traditional Chinese Medicine Clinical Terminological System version2.0 were described, the principles and specific methods for the selection of syndrome concepts and establishment of relationship between syn-drome concepts in Traditional Chinese Medicine Clinical Terminological system version2.0 were studied according to its general revision principles in the light of relevant standards in traditional Chinese medicine, various editions of teaching materials and medical records, the advantages of descriptive definition and logical definition of syndrome concepts,and the establishment of relationship between syndrome concepts derived from syndrome concepts were elaborated.
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Traditional Chinese medicine (TCM) clinical symptoms, which were main evidences in syndrome differentiation and treatment, were also main data in the clinical individual diagnosis and treatment. However, the absence of high-quality symptom ontology was still obvious in TCM clinical and data using. By analyzing the research and data of clinical phenotype ontologies associated with symptoms, this paper was aimed to introduce and sort the existing ontologies, in order to discuss related problems. Furthermore, we provided ideas and expound the importance of building data network of symptoms, diseases, genes, drugs, chemicals, side effects with the data we collected and disposed around symptoms, in order to construct TCM clinical phenotype ontology. We believed that our work will help the development of individual treatment and precision medicine in TCM. It was also the key of individual big data analysis which was urgent need to promote.
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This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).
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This study was aimed to define the scope of traditional Chinese medicine (TCM) informatics standards. The basic construction of three-dimensional profiling framework includes TCM business domain, elements of TCM informationization and specificity level. The clinical informatics standards development was stated as an example to demonstrate the application method of this three-dimensional profiling framework.
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Objective To investigate the effect of treating cervical spondylotic radiculopathy with traditional Chinese medicine. Methods 110 patients with cervical spondylotic radiculopathy were treated with traditional Chinese medical pathway: Chinese herbal medicine soaking (incised notoptetygium rhizome, Chinese angelica, divaricate saposhnikovia root, safflower, dahurian angelica root, myrrh, common floweringqince fruit, and tuberculate speranskia herb, etc.)-Acupuncture-cervical traction-massage, once daily, 10 times as a course of treatment. After two courses, therapeutic effect score was analyzed. Results Of all 110 cases, 35 cases(31.82%)were cured; 53 cases(48.18%)had obvious effectiveness; 17 cases(15.45%)had effectiveness; 5 cases(4.55%)had no effectiveness. The total efficiency was 95.45%. The patient's age(χ2=0.296), sex(U=0.023), and duration of disease(χ2=0.577)had no significant effect on the efficacy(P>0.05);After the treatment, neck pain, upper extremity pain, upper extremity numbness, neck tenderness, intervertebral foramina compression test, sensory disturbances limbs, myodynamia of upper limbs, and tendon reflexes were significantly improved compared with before treatment, with significant difference(t=16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367,P<0.05). Conclusion The use of traditional Chinese medicine clinical pathway in treating cervical spondylotic radiculopathy was effective and it could improve the quality of medical care.
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Real world clinical diagnosis and treatment activity is a complicated decision-making task. The effective clinical cases of traditional Chinese medicine (TCM) of highly experienced physicians play an important role in the routine diagnosis and treatment and the formulation of medical knowledge . Based on TCM electronic medical record data, this paper proposed a decision support prototype system on TCM clinical diagnosis and treatment based on TCM effective clinical cases and case-based reasoning (CBR) algorithm, which is used to assist inexperienced clinicians to make more reliable clinical decisions, and thereafter to improve the clinical curative effectiveness. The system integrates TCM clinical cases data set from a TCM clinical data warehouse, and retrieves the similar cases based on CBR method. In particular, according to the underlying personalized diagnosis and treatment for patients in TCM, this system implemented a flexible diagnosis and treatment modification mechanism based on correlation analysis among symptoms, diagnoses (syndrome or pattern in TCM) and medicine. Finally, through a demonstration of clinical application, we made an initial evaluation of the usefulness and practical effects of the system.
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This study was aimed to investigate structured approach of traditional Chinese medicine (TCM) symptom information. Combining results of the Chinese Symptomatology Research and literature review, this study proposed a dual structure model of symptom. A total of 440 symptoms, which were screened out from the Chinese Terms in TCM and Pharmacy, were used for symptom structured attempt. The results showed that 9 symptoms and 9 attributes were identified, 201 main concept words of symptoms were extracted, and 420 symptoms with the dual structure model were structured. It was concluded that structural information model of TCM symptoms proposed in this study was feasible. However, the research methods and results are exploratory, which requires further verification.
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Objective To analyze the effect of implementing traditional Chinese medicine (TCM) clinical pathway on family sickbed patients.Methods Those family sickbed patients with herpes zoster or facial neuritis were involved in this study.Their medical records and data of ‘Family sickbed quality control scale’ were collected,in which there are methods of TCM clinical pathway,decoction of the Chinese Medicine,ingredients and treatment procedures of the topically used TCMs,and acupuncture treatment procedures were documented.The family sickbed days,prognosis,informed rate and satisfaction rate were analyzed before and after TCM clinical pathway treatment.Results In the treatment group,the family sickbed days (11.67± 1.91)d and referral rate 12.20％ (10/82) were significantly lower (P＜ 0.01) than those in the control group [(1 3.88 ± 2.61) d,50.00％ (41/82) respectively].The rate of cure87.80％ (72/82),the rate of informed patient 97.56％ (80/82) and the rate of satisfaction91.46％ (75/82) were significantly higher(P＜ 0.01)than those in the control group [50.00％ (41/82)、65.85％ (54/82)、50.00％ (41/82) respectively].Conclusion The clinical pathways for family sickbed patients with herpes zoster or facial neuritis were effective.
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This article was aimed to explore the intelligent integration of database as the core-data and application of data mining as the core of knowledge discovery. On the basis of the existed set of information-sharing platform, this article elaborated from aspects of formatting HER intelligent integration, data integration and multi-method combined data mining intelligent integration. With the demonstration study on syndrome distribution and syndrome diagnostic criteria of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), data integration and intelligence optimization of Crystal Reports and complex networks were applied to dig out the correlation between syndromes and symptoms, disease-syndromes-herb association analysis. Analysis mentioned above showed that based on the shared system, and in accordance to research programs, intelligent integration of data and data mining methods, the improvement of the sharing platform application is proved feasible.