A Survey of Attitudes to Traditional Chinese Medicine Among Chinese Medical Students

Attitude, knowledge, and barriers of Chinese clinical and nursing students in implementing complementary and alternative medicine for COVID-19：a cross-sectional study

Background

Complementary and alternative medicine (CAM) has emerged to combat the global COVID-19 pandemic. However, no studies have been conducted to evaluate the attitudes, knowledge, and barriers of Chinese clinical and nursing students in implementing CAM during this period.

Objective

The aim of this study was to investigate the attitude, knowledge, and barriers of Chinese clinical and nursing students in using CAM in the context of COVID-19.

Methods

An online-based cross-sectional survey was carried out among Chinese medical students, majoring in clinical medicine or nursing, in Nanjing, Jiangsu Province, and Zhengzhou, Henan Province from May to July 2022. A total of 402 clinical and 644 nursing students responded to a self-administered questionnaire through the Questionnaire Star and WeChat APPs. SPSS 25 (version 25) was used for data analysis. Proportions were compared by Chi-square test. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test.

Results

The average score of attitude was 46.63 (SD: 7.38) in clinical students and 49.84 (SD: 6.76) in nursing students. The top four most commonly used CAM treatments in China were proprietary Chinese medicine, diet therapy, decoction, and acupuncture and moxibustion (59.66 %, 22.28 %, 11.66 %, 9.85 %). The students had a good mastery of knowledge about CAM-based prevention and control of COVID-19 (mean score 7.36). The score of CAM knowledge in nursing students was significantly higher than that in clinical students (7.56 VS 7.04, P = 0.000). Gender, grade, previous use, age, and knowledge score could affect students' attitude towards CAM. The main barriers in spreading CAM use included time-consumption, bad taste, and fear of treatment-related pain (24.5 %). Compared with clinical students, nursing students were more likely to recommend CAM to patients in the future (P = 0.002).

Conclusions

During the COVID-19 pandemic, nursing students were more positive towards CAM use, had a better mastery of CAM knowledge than clinical students. CAM is expected to provide better outcomes in COVID-19 patients. Future studies should focus on the changes in students' attitudes over time and exploration of influencing factors on CAM use.

Cultural persistence and the 'herbal medicine paradox': Evidence from European data

The use of herbal or traditional medicines has survived the proliferation of modern medicine. The phenomenon has been labeled as the 'herbal medicines paradox' (HMP). We study whether such HMP hypothesis can be explained by the persistence of attitudes across cultural boundaries. We undertake a secondary analysis of individual-level migration data to test the persistence of the use of herbal medicines in relation to norms in the person's country of birth (or home country). We study the association between attitudes towards herbal medicine treatments of both first (N = 3630) and second-generation (N = 1618) immigrants in 30 European countries, and the average attitudes of their sending country origins. We find robust evidence of an association that is stronger for the second-generation migrants. We document a stronger effect among maternal than paternal lineages, as well as significant heterogeneity based on migrants' country of origin. Our estimates are robust to different sample analysis. Our estimates are consistent with a cultural explanation for the HMP.

Predictors of the intention to use traditional Chinese medicine (TCM) using extended theory of planned behavior: a cross-sectional study among TCM users in Hong Kong

Background

Traditional Chinese medicine (TCM) and Western medicine are available and have a long history in Hong Kong. Little is known on the intention to use TCM in Hong Kong. In this study, the intention to use TCM was examined by the extended theory of planned behavior.

Methods

An online cross-sectional survey was conducted from 15 and 29 November 2021. Respondents’ attitude towards using TCM, intention to use TCM, knowledge, perceived behavioral control, perceived service quality, satisfaction, subjective norms and demographic characteristics were collected from the survey. To examine the conceptual framework in this study, partial least square structural equation model (PLS-SEM) was adopted.

Results

In total, 446 responses (completion rate = 74.3%) were analysed. Attitude towards TCM was the strongest predictor to the intention to use TCM followed by satisfaction and subjective norms. Attitude had a partial mediating effect on the relationship between subjective norms, perceived behavioral control and intention to use TCM. Attitude had a full mediating effect on the relationship between knowledge and intention to use TCM. Satisfaction had a full mediating effect on the relationship between perceived service quality and intention to use TCM.

Conclusions

This is the first study to investigate the predictors of the intention to use TCM in Hong Kong by using TPB. Individuals’ attitude towards TCM has showed stronger effect to the intention to use TCM than other predictors, such as satisfaction, perceived behavioral control and subjective norms. To enhance the intention to use TCM in Hong Kong, key stakeholders, including TCM professional organisations, health professionals and policymakers, should develop a positive attitude towards TCM among Hong Kong population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03598-x.

Experimental Drugs with the Potential to Treat Atopic Eczema

Introduction

Eczema or atopic dermatitis (AD) is a chronically relapsing dermatosis characterized by pruritus and a significant impact on the quality of life.

Methods

The authors undertook a structured search of peer-reviewed research articles from PubMed and Google Scholar. Recent and up-to-date studies relevant to the topic were included.

Results

This report overviews current treatment and experimental drug for AD. Topical agents including topical phosphodiesterase E4 (PDE4) inhibitors such as crisaborole are efficacious in the treatment of AD with few side effects. Monoclonal antibodies such as dupilumab given subcutaneously are efficacious for more severe disease. Systemic treatment can ameliorate symptoms in severe and recalcitrant AD. New systemic treatment includes several traditional herbal formulations that have undergone clinical trials using modern research methodology to determine their efficacy and safety. AD is associated with many complicating psychosocial issues. Often suboptimal efficacy is due to unrealistic expectations and poor compliance making treatment difficult in spite of effective treatment and efforts in drug discovery. Randomized trials have shown that novel topical and subcutaneous medications are safe and efficacious. Regarding herbs, a methodology for the investigation of herbal medications is often flawed and scientific evidence is lacking. Experimental drugs include various biologics, PDE4 and JAK inhibitors in topical, oral, subcutaneous or intravenous forms are in various phases of trials.

Conclusion

Many novel medications demonstrate efficacy for AD. Experimental drugs include various biologics, PDE4 and JAK inhibitors are in various phases of trials.

Knowledge of medical professionals, their practices, and their attitudes toward traditional Chinese medicine for the prevention and treatment of coronavirus disease 2019: A survey in Sichuan, China

This study aimed to investigate the knowledge, practices, and attitudes of medical professionals toward Traditional Chinese Medicine (TCM) for the prevention and treatment of coronavirus disease 2019 (COVID-19). All 401 medical professionals were surveyed using an anonymous with an investigator using the Questionnaire star APP. The participants answered 14 questions; of the 401 participants, 55.2% agreed with the statement “TCM can be used for the prevention and treatment of COVID-19,” 40.4% remained neutral, and 4.4% disagreed. Moreover, 75.3% agreed with the statement “There is no specific drug for COVID-19,” 67% agreed with the statement “TCM can develop immunity to COVID-19” and 62.1% agreed with “TCM can alleviate the symptoms of patients with COVID-19.” Meanwhile, 69.1% were aware that TCM has been recommended for COVID-19 by the National Health Commission of the People’s Republic of China. Regarding the selection of sources of knowledge on whether “TCM can be used for the prevention and treatment of COVID-19,” There were 277, 123, 82, 369, and 17 participants selected sources from “Hospital training,” “Academic journals,” “Academic Conferences,” “Social media platforms (such as WeChat)” and “Others,” respectively. Further, 358 participants will take TCM for the prevention of COVID-19. Multiple logistic regression analysis showed that age, major and received TCM treatment within the last five years were independent factors affecting the participants’ attitudes. In the absence of specific drugs for COVID-19, more than half of the participants agreed that TCM could be used for the prevention and treatment of COVID-19 and most participants are willing to take TCM to prevent COVID-19, although unsure about its effectiveness. The main information sources on TCM for the treatment and prevention of COVID-19 were social platforms and hospital training.

A Survey on Perceptions of Complementary and Alternative Medicine among Undergraduates in China

In recent years, complementary and alternative medicine (CAM) is more widely known and used globally. This study was the first to investigate undergraduates' attitude toward CAM, and influencing factors and barriers for students to use CAM. Students of five different grades in six universities of China were selected for this study from February to May 2019. First, the participants were divided into two groups based on their majors and fulfilled a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) to evaluate their attitudes toward CAM. Second, the chi-square test was used to analyze the differences between the groups, and correlation analysis was conducted to investigate the relationship of the data between the two groups. Third, we used frequency analysis to identify the types that students wanted to study and the barriers to use CAM. The overall mean score of the CHBQ was 48.87 ± 8.594, which was higher than that in other countries. The students in lower grades had a stronger desire to learn CAM than those in higher grades (89% vs 83%, p < 0.05). “Too time-consuming and bad tastes,” “Western medicine was enough,” and “lack of relevant knowledge” were found to be the main interruptions for students to use CAM. 82.3% of students wanted CAM to be incorporated into the curriculum and desired to learn more about CAM. 72.3% of the students who had never learned CAM wanted to know more about CAM. 55.5% of the students were willing to recommend CAM. Most undergraduates desired to learn more about CAM. It is necessary to introduce or integrate CAM courses into the present curriculum, and it should be started in the lower grades. We hope this study can provide evidence for the authority in China to make appropriate changes and integrate CAM into the college curriculum.

An overview of drug discovery efforts for eczema: why is this itch so difficult to scratch?

Introduction: Atopic dermatitis (AD) is a type of allergic/inflammatory dermatitis characterized by itch and an impairment in quality of life.Areas covered: Herein, the authors review drug discovery efforts for AD, highlighting the clinical efficacy of novel drugs, with a particular focus on the relief of pruritus. Topical agents include emollients, topical antihistamines, corticosteroids, calcineurin inhibitors and herbs. Recently, topical phosphodiesterase E4 (PDE4) inhibitors like crisaborole have become available and are efficacious for mild to moderate AD with few side effects. For more severe AD, monoclonal antibodies like dupilumab are considered as efficacious subcutaneous treatment options. In severe and recalcitrant AD, systemic treatment can ameliorate AD symptoms.Expert opinion: Many topical and systemic medications have demonstrated therapeutic benefits for AD. Indeed, randomized trials have shown that topical PDE4 inhibitors and subcutaneous dupilumab are safe and efficacious. Objective tools to evaluate itch and gauge treatment efficacy is important, but current methodology relies primarily on clinical scores. AD is a systemic atopic disease with a lot of complicated psychosocial issues. Suboptimal efficacy is often due to poor compliance and unrealistic expectation of curative treatment, rendering treatment difficult despite the existence of effective medications.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

A cross-sectional study on knowledge and attitude toward Traditional Chinese Medicine (TCM) among adults in selected regions of Malaysia

BACKGROUND

The objectives of this study were to determine the knowledge and attitude of adult Malaysians about Traditional Chinese Medicine (TCM), to understand the variation in the knowledge and attitude toward TCM among different demographic groups of adult Malaysian population and to determine the pattern of TCM use among adult Malaysians.

METHODS

This study was a descriptive, cross-sectional survey using the convenience sampling method. A total of 400 adult Malaysians were recruited for this study. An interview-administered questionnaire was used. Descriptive statistics Mann-Whitney U Test and Kruskal-Wallis H test were used to analyze the data. The reliability of survey data in this study may affect since closed-ended questions are used.

RESULTS

The more commonly utilized therapy was herbal medicine (n=192, 82.1%), acupuncture (n=79, 33.8%) and oriental massage (n=58, 24.8%). The mean knowledge score and mean attitude score for the respondents were 5.00±1.71 and 7.17±2.10 respectively. There was a significant difference in the mean knowledge score between genders, among TCM users and non-TCM users, people of different education levels and ethnicity.

CONCLUSIONS

There were more TCM users than non-TCM users and the use of TCM was higher in females than males. The most popularly used TCM modalities were herbal medicines and acupuncture. Gender, education, ethnicity and use of TCM had a significant effect on adults' knowledge toward TCM.

The effects of five alkaloids from Bulbus Fritillariae on the concentration of cAMP in HEK cells transfected with muscarinic M(2) receptor plasmid

The aim of this study was to investigate the effects of five alkaloids, namely verticine, verticinone, imperialine, imperialine-3beta-D-glucoside, and puqietinone, purified from Bulbus Fritillariae and used as an antitussive drug in traditional Chinese medicine, on their antimuscarinic M(2) function and the cAMP level of HEK cells transfected with muscarinic M(2) receptor plasmid. By transfecting the HEK cells with the method of calcium phosphate co-precipitation and screening with G418, the cells stably expressing M(2) receptor were identified. The expression of M(2) receptor in HEK cells was confirmed by both RT-PCR and western blot. The cAMP level in the treated cells was analyzed with RIA method ((125)I-cAMP KIT). And the results suggested that the five alkaloids could significantly elevate the cAMP concentration in the HEK cells transfected with muscarinic M(2) receptor plasmid (p < 0.01).

Chinese Nursing Students' Attitudes Toward Traditional Chinese Medicine

In this study, we examined Chinese nursing students' attitudes toward and use of traditional Chinese medicine (TCM). Survey questionnaires were distributed to 439 nursing students, 263 of whom (60%) returned them. Of the respondents, 92% had used TCM, while 48% had used TCM at least once during the previous year. Forty-five percent of respondents reported positive attitudes toward TCM use, 52% had neutral attitudes, and only 3% reported negative attitudes. The majority of respondents (76%) reported no change in their attitude toward TCM after studying nursing. Mean scores related to the adequacy of the current curriculum in TCM training and the state of respondents' TCM knowledge were generally low. Of the respondents who had used TCM during the past year, the most common use was for upper respiratory tract infection. The most common type of TCM used by respondents was herbal tea or soup. Final-year nursing students were more likely to have used TCM during the previous year, report they would like more courses on TCM, and consult Western medicine physicians before using TCM; they were also less likely to develop more negative attitudes toward TCM after studying nursing.