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Zhao M, Zhou H, Wang J, Liu Y, Zhang X. A new method for identification of traditional Chinese medicine constitution based on tongue features with machine learning. Technol Health Care 2024:THC240128. [PMID: 38875060 DOI: 10.3233/thc-240128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
BACKGROUND The theory of Chinese medicine (TCM) constitution contributes to the optimisation of individualised healthcare programmes. However, at present, TCM constitution identification mainly relies on inefficient questionnaires with subjective bias. Efficient and accurate TCM constitution identification can play an important role in individualised medicine and healthcare. OBJECTIVE Building an efficient model for identifying traditional Chinese medicine constitutions using objective tongue features and machine learning techniques. METHODS The DS01-A device was applied to collect tongue images and extract features. We trained and evaluated five machine learning models: Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), LightGBM (LGBM), and CatBoost (CB). Among these, we selected the model with the best performance as the base classifier for constructing our heterogeneous ensemble learning model. Using various performance metrics, including classification accuracy, precision, recall, F1 score, and area under curve (AUC), to comprehensively evaluate model performance. RESULTS A total of 1149 tongue images were obtained and 45 features were extracted, forming dataset 1. RF, LGBM, and CB were selected as the base learners for the RLC-Stacking. On dataset 1, RLC-Stacking1 achieved an accuracy of 0.8122, outperforming individual classifiers. After feature selection, the classification accuracy of RLC-Stacking2 improved to 0.8287, an improvement of 0.00165 compared to RLC-Stacking1. RLC-Stacking2 achieved an accuracy exceeding 0.85 for identifying each TCM constitution type, indicating excellent identification performance. CONCLUSION The study provides a reliable method for the accurate and rapid identification of TCM constitutions and can assist clinicians in tailoring individualized medical treatments based on personal constitution types and guide daily health care. The information extracted from tongue images serves as an effective marker for objective TCM constitution identification.
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Lee CH, Tsai CI, Su YC, Lin SY, Lee IT, Li TC. Traditional Chinese medicine body constitution predicts new-onset diabetic albuminuria in patients with type 2 diabetes: Taichung diabetic body constitution prospective cohort study. Medicine (Baltimore) 2022; 101:e32342. [PMID: 36550881 PMCID: PMC9771319 DOI: 10.1097/md.0000000000032342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This prospective cohort study explored whether body constitution (BC) independently predicts new-onset albuminuria in persons with type 2 diabetes mellitus (T2DM) enrolled in the diabetes care management program (DCMP) of a medical center, providing evidence of integrating traditional Chinese medicine into DCMP for improving care quality. Persons with T2DM (n = 426) originally without albuminuria enrolled in DCMP were recruited in 2010 and were then followed up to 2015 for detecting new-onset albuminuria. The participants received urinalysis and blood test annually. Albuminuria was determined by an elevated urinary albumin/creatinine ratio (≥ 30 µg/mg), and poor glucose control was defined as Glycosylated hemoglobin above or equal to 7%. BC type (Yin deficiency, Yang deficiency, and phlegm stasis) was assessed using a well-validated body constitution questionnaire at baseline. Risk factors for albuminuria (sociodemographic factors, diabetes history, lifestyle behaviors, lipid profile, blood pressure, and kidney function) were also recorded. Hazard ratios (HR) of albuminuria for BC were estimated using multivariate Cox proportional hazards model. During the 4-year follow-up period, albuminuria occurred in 30.5% of participants (n = 130). The HR indicated that Yin deficiency was significantly associated with an increased risk of new-onset albuminuria in persons with T2DM and good glucose control after adjustment for other risk factors (HR = 2.09; 95% confidence interval = 1.05-4.17, P = .04), but not in those with poor glucose control. In persons with T2DM and poor glucose control, phlegm stasis was also significantly associated with a higher risk of albuminuria (2.26; 1.03-4.94, P = .04) after multivariate adjustment, but not in those with good glucose control. In addition to already-known risk factors, BC is an independent and significant factor associated with new-onset albuminuria in persons with T2DM. Our results imply Yin deficiency and phlegm stasis interacting with glucose control status may affect new-onset albuminuria in persons with T2DM.
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Affiliation(s)
- Cheng-Hung Lee
- Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post‐Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Center for General Education of Tunghai University, Tunghai University, Taichung, Taiwan
| | - Chia-I Tsai
- Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post‐Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Center for General Education of Tunghai University, Tunghai University, Taichung, Taiwan
| | - Yi-Chang Su
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan
| | - Shih-Yi Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- * Correspondence: Tsai-Chung Li, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung City 406040, Taiwan R.O.C. (e-mail: )
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Association between Resting Energy Expenditure and Heat Pattern in Traditional Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4093731. [PMID: 32308707 PMCID: PMC7132353 DOI: 10.1155/2020/4093731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/29/2020] [Accepted: 02/12/2020] [Indexed: 11/17/2022]
Abstract
Many symptoms of heat pattern (HP) in traditional medicine are related to thermoregulation; however, research on the association between energy expenditure characteristics and HP is limited. We aimed to study the association between HP and resting energy expenditure (REE). A total of 109 participants were divided into the HP and non-HP groups based on a self-administered questionnaire and their REE was measured using an indirect calorimeter. Multiple logistic regression models were used to calculate the odds ratio (OR) of HP according to the level of REE. No significant differences in age, anthropometric, and body composition characteristics were observed between the HP and the non-HP groups. The likelihood of having an HP significantly increased with higher REE after adjustment for fat-free mass (OR 1.22 [95% CI 1.03-1.46]) and also after additional adjustment for sex and age (OR 1.21 [95% CI 1.01-1.46]). These results suggest that increased REE could be a biological characteristic of HP. Future studies are necessary to investigate the underlying mechanisms associated with the differing energy expenditure in HP.
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Jacobson E, Conboy L, Tsering D, Shields M, McKnight P, Wayne PM, Schnyer R. Experimental Studies of Inter-Rater Agreement in Traditional Chinese Medicine: A Systematic Review. J Altern Complement Med 2019; 25:1085-1096. [PMID: 31730402 PMCID: PMC6864748 DOI: 10.1089/acm.2019.0197] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objectives: It has been recommended that clinical trials of Traditional Chinese Medicine (TCM) would be more ecologically valid if its characteristic mode of diagnostic reasoning were integrated into their design. In that context, however, it is also widely held that demonstrating a high level of agreement on initial TCM diagnoses is necessary for the replicability that the biomedical paradigm requires for the conclusions from such trials. Our aim was to review, summarize, and critique quantitative experimental studies of inter-rater agreement in TCM, and some of their underlying assumptions. Design: Systematic electronic searches were conducted for articles that reported a quantitative measure of inter-rater agreement across a number of rating choices based on examinations of human subjects in person by TCM practitioners, and published in English language peer-reviewed journals. Publications in languages other than English were not included, nor those appearing in other than peer-reviewed journals. Predefined categories of information were extracted from full texts by two investigators working independently. Each article was scored for methodological quality. Outcome measures: Design features across all studies and levels of inter-rater agreement across studies that reported the same type of outcome statistic were compared. Results: Twenty-one articles met inclusion criteria. Fourteen assessed inter-rater agreement on TCM diagnoses, two on diagnostic signs found upon traditional TCM examination, and five on novel rating schemes derived from TCM theory and practice. Raters were students of TCM colleges or graduates of TCM training programs with 3 or more years experience and licensure. Type of outcome statistic varied. Mean rates of pairwise agreement averaged 57% (median 65, range 19-96) across the 9 studies reporting them. Mean Cohen's kappa averaged 0.34 (median 0.34, range 0.07-0.59) across the seven studies reporting them. Meta-analysis was not possible due to variations in study design and outcome statistics. High risks of bias and confounding, and deficits in statistical reporting were common. Conclusions: With a few exceptions, the levels of agreement were low to moderate. Most studies had significant deficits of both methodology and reporting. Results overall suggest a few design features that might contribute to higher levels of agreement. These should be studied further with better experimental controls and more thorough reporting of outcomes. In addition, methods of complex systems analysis should be explored to more adequately model the relationship between clinical outcomes, and the series of diagnoses and treatments that are the norm in actual TCM practice.
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Affiliation(s)
- Eric Jacobson
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Lisa Conboy
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences University, Worcestor, MA
| | | | - Monica Shields
- New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences University, Worcestor, MA
| | | | - Peter M. Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Rosa Schnyer
- Department of Adult Health, School of Nursing, University of Texas, Austin, TX
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Association of TCM body constitution with insulin resistance and risk of diabetes in impaired glucose regulation patients. Altern Ther Health Med 2017; 17:459. [PMID: 28893239 PMCID: PMC5594579 DOI: 10.1186/s12906-017-1964-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 09/01/2017] [Indexed: 12/16/2022]
Abstract
Background Impaired glucose regulation (IGR) patients have increased risk of type 2 diabetes mellitus (T2DM). Identifying relevant risk factors in IGR subjects could facilitate early detection and prevention of IGR progression to diabetes. This study investigated the association between Traditional Chinese Medicine (TCM) body constitution and serum cytokines, and whether body constitution could independently predict diabetes in IGR subjects. Method Patients with IGR (n = 306) received a blood test and their body constitution type was assessed using a body constitution questionnaire (BCQ). Serum levels of cytokines were measured by ELISA. Patients were followed up for at least three years, and their status of diabetes were recorded. Multivariate logistic regression was used to estimate odds ratios (ORs) of diabetes for body constitution. Results Phlegm-damp, Damp-heat and Qi-deficiency were three most common unbanlenced constitutions among IGR subjects. Phlegm-damp and Damp-heat constitution subjects showed higher serum levels of interleukin 6 (IL-6), tumour necrosis factor-α (TNF-α), leptin and lower serum levels of adiponectin (P<0.05). Qi-deficiency constitution subjects showed higher serum levels of leptin and lower serum levels of adiponectin, glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) (P<0.05). Subjects with Phlegm-damp or Damp-heat constitution demonstrated a significantly higher risk of diabetes (P<0.05). Conclusion Phlegm-damp and Damp-heat TCM body constitution are strongly associated with abnormal serum cytokines, and could potentially serve as a predictor of diabetes in IGR subjects. Body constitution can help to identify IGR subjects who are at a high risk of progression to diabetes.
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Shen L, Ye B, Sun H, Lin Y, van Wietmarschen H, Shen B. Systems Health: A Transition from Disease Management Toward Health Promotion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1028:149-164. [PMID: 29058221 DOI: 10.1007/978-981-10-6041-0_9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To date, most of the chronic diseases such as cancer, cardiovascular disease, and diabetes, are the leading cause of death. Current strategies toward disease treatment, e.g., risk prediction and target therapy, still have limitations for precision medicine due to the dynamic and complex nature of health. Interactions among genetics, lifestyle, and surrounding environments have nonnegligible effects on disease evolution. Thus a transition in health-care area is urgently needed to address the hysteresis of diagnosis and stabilize the increasing health-care costs. In this chapter, we explored new insights in the field of health promotion and introduced the integration of systems theories with health science and clinical practice. On the basis of systems biology and systems medicine, a novel concept called "systems health" was comprehensively advocated. Two types of bioinformatics models, i.e., causal loop diagram and quantitative model, were selected as examples for further illumination. Translational applications of these models in systems health were sequentially discussed. Moreover, we highlighted the bridging of ancient and modern views toward health and put forward a proposition for citizen science and citizen empowerment in health promotion.
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Affiliation(s)
- Li Shen
- Center for Systems Biology, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu, 215006, China
| | - Benchen Ye
- Center for Systems Biology, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu, 215006, China
| | - Huimin Sun
- Collaborative Innovation Center of Sustainable Forestry in Southern China of Jiangsu Province, Nanjing Forestry University, Nanjing, 210037, China
| | - Yuxin Lin
- Center for Systems Biology, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu, 215006, China
| | | | - Bairong Shen
- Center for Systems Biology, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu, 215006, China.
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Chung VC, Ho RS, Wu X, Wu JC. Incorporating traditional Chinese medicine syndrome differentiation in randomized trials: Methodological issues. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.08.164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Mujagic Z, Keszthelyi D, Aziz Q, Reinisch W, Quetglas EG, De Leonardis F, Segerdahl M, Masclee AAM. Systematic review: instruments to assess abdominal pain in irritable bowel syndrome. Aliment Pharmacol Ther 2015; 42:1064-81. [PMID: 26290286 DOI: 10.1111/apt.13378] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/02/2015] [Accepted: 07/31/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Consensus on standard methods to assess chronic abdominal pain in patients with irritable bowel syndrome (IBS) is currently lacking. AIM To systematically review the literature with respect to instruments of measurement of chronic abdominal pain in IBS patients. METHODS Systematic literature search was performed in PubMed/Medline databases for studies using pain measurement instruments in patients with IBS. RESULTS One hundred and ten publications were reviewed. A multitude of different instruments is currently used to assess chronic abdominal pain in IBS patients. The single-item methods, e.g. the validated 10-point numeric rating scale (NRS), and questionnaires assessing gastrointestinal symptoms severity, focus mostly on the assessment of only the intensity of abdominal pain. Of these questionnaires, the validated IBS-Symptom Severity Scale includes the broadest measurement of pain-related aspects. General pain questionnaires and electronic momentary symptom assessment tools have been used to study abdominal pain in IBS patients, but have not yet been validated for this purpose. The evidence for the use of provocation tests, e.g. the rectal barostat with balloon distention, for measurement of abdominal pain in IBS is weak, due to the poor correlation between visceral pain thresholds assessed by provocation tests and abdominal pain as assessed by retrospective questionnaires. CONCLUSIONS The multitude of different instruments to measure chronic abdominal pain in IBS makes it difficult to compare endpoints of published studies. There is need for validated instruments to assess chronic abdominal pain in IBS patients, that overcome the limitations of the currently available methods.
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Affiliation(s)
- Z Mujagic
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - D Keszthelyi
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Q Aziz
- Centre for Digestive Diseases, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - W Reinisch
- Department Internal Medicine III, Medical University of Vienna, Vienna, Austria.,McMaster University, Hamilton, ON, Canada
| | - E G Quetglas
- Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany
| | - F De Leonardis
- Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany
| | - M Segerdahl
- Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany.,Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - A A M Masclee
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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Lee CH, Li TC, Tsai CI, Lin SY, Lee IT, Lee HJ, Wu YC, Su YC. Association between Albuminuria and Different Body Constitution in Type 2 Diabetes Patients: Taichung Diabetic Body Constitution Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:603048. [PMID: 26587046 PMCID: PMC4637481 DOI: 10.1155/2015/603048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 10/04/2015] [Indexed: 11/17/2022]
Abstract
Objective. Albuminuria in type 2 diabetes mellitus (T2DM) patients increases the risk of diabetic nephropathy, the leading cause of end-stage renal disease worldwide. Because albuminuria is modifiable, identifying relevant risk factors could facilitate prevention and/or management. This cross-sectional study investigated whether body constitution (BC) independently predicts albuminuria. Method. Patients with T2DM (n = 846) received urinalysis, a blood test, and diabetic retinopathy examination. Albuminuria was defined by an elevated urinary albumin/creatinine ratio (≥30 μg/mg). BC type (Yang deficiency, Yin deficiency, and Phlegm stasis) was assessed using a body constitution questionnaire (BCQ). Traditional risk factors for albuminuria were also recorded. Odds ratios (ORs) of albuminuria for BC were estimated using multivariate logistic regression. Results. Albuminuria was more prevalent in patients with Yang deficiency or Phlegm stasis (both P < 0.01). After adjustment, patients with both Yang deficiency and Phlegm stasis exhibited a significantly higher risk of albuminuria (OR = 3.037; 95% confidence interval = 1.572-5.867, and P < 0.001). Conclusion. BC is strongly associated with albuminuria in T2DM patients. Using a BCQ to assess BC is noninvasive, convenient, and inexpensive and can provide information for health care professionals to identify T2DM patients who are at a high risk of albuminuria.
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Affiliation(s)
- Cheng-Hung Lee
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Traditional Chinese Medicine, Han Ming Hospital, Changhua 50072, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung 40402, Taiwan
- Department of Health Administration, College of Health Science, Asian University, Taichung 41354, Taiwan
| | - Chia-I Tsai
- Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Shih-Yi Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Hsin-Jung Lee
- Division of New Drugs, Center for Drug Evaluation, Taipei 11557, Taiwan
| | - Ya-Chi Wu
- Division of New Drugs, Center for Drug Evaluation, Taipei 11557, Taiwan
| | - Yi-Chang Su
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
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Methodological challenges in mapping chinese medicine syndrome with conventional diagnosis: Implications for multi-centre trials in integrative medicine. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.07.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Extraction of Clinical Indicators That Are Associated with the Heat/Nonheat and Excess/Deficiency Patterns in Pattern Identifications for Stroke. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:869894. [PMID: 26089950 PMCID: PMC4452190 DOI: 10.1155/2015/869894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/29/2014] [Indexed: 11/29/2022]
Abstract
The aim of this study is to extract indicators that are associated with the heat/nonheat and excess/deficiency patterns in stroke pattern identification through the large-scale analysis of clinical data. Two experts, who had more than three years of clinical experience with stroke, independently performed the pattern identification. We analyzed indicators of clinical data with two doctors' concurrent diagnoses on the patient's pattern identification. To verify heat/nonheat and excess/deficiency patterns, which are the basic elements of pattern identification, we grouped 960 patients diagnosed as the fire-heat pattern, the Yin deficiency pattern, and the Qi deficiency pattern in to two groups, the heat/nonheat group and the excess/deficiency group. We then extracted significant indicators using univariate and multivariate analysis. As a result of the comparison of 65 indicators, we were able to extract 10 indicators for the heat pattern, 6 for the nonheat pattern, 9 for the excess pattern, and 10 for the deficiency pattern. Extracted indicators in this study can be used for pattern identification in the context of stroke. These are positive indicators from large-scale clinical studies and are greatly expected to be crucial discriminant indicators in individual pattern identification henceforth.
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Lee CH, Li TC, Tsai CI, Lin SY, Lee IT, Lee HJ, Wu YC, Su YC. Yang Deficiency Body Constitution Acts as a Predictor of Diabetic Retinopathy in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:940898. [PMID: 26167195 PMCID: PMC4475744 DOI: 10.1155/2015/940898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/19/2015] [Indexed: 12/14/2022]
Abstract
Objective. Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus (DM), can cause severe visual impairment and blindness. To prevent the development of DR, identifying the associated risk factors for patient classification is critical. We conducted a cross-sectional study to determine whether body constitution (BC) is an independent predictor of DR. Method. 673 type 2 DM (T2DM) patients were recruited from a medical center, all received DR examination and body constitution questionnaire to assess BC. Other risk factors for DR were also recorded, including life style, history of diabetes, and blood pressure, etc. Multiple logistic regression analysis was conducted to calculate the odds ratios (ORs) for DR. Results. The prevalence of DR was significantly lower in Yang deficiency patients compared with non-Yang deficiency patients (24.69% versus 38.18% P = 0.02). After adjusting for other risk factors, we observed that patients exhibiting Yang deficiency BC were less likely to present with DR (OR = 0.531; 95% confidence interval = 0.312-0.903, P = 0.018). Conclusion. In addition to traditional risk factors, Yang deficiency BC might be an independent predictor of DR among T2DM patients and the results can be used as evidence for traditional Chinese medicine patient classification.
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Affiliation(s)
- Cheng-Hung Lee
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Traditional Chinese Medicine, Han Ming Hospital, Changhua, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
- Department of Health Administration, College of Health Science, Asian University, Taichung, Taiwan
| | - Chia-I Tsai
- Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-Yi Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Jung Lee
- Division of New Drugs, Center for Drug Evaluation, Taipei, Taiwan
| | - Ya-Chi Wu
- Division of New Drugs, Center for Drug Evaluation, Taipei, Taiwan
| | - Yi-Chang Su
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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Xiao HT, Zhong L, Tsang SW, Lin ZS, Bian ZX. Traditional Chinese medicine formulas for irritable bowel syndrome: from ancient wisdoms to scientific understandings. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2015; 43:1-23. [PMID: 25579759 DOI: 10.1142/s0192415x15500019] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Traditional Chinese Medicine (TCM) serves as the most common alternative therapeutic approach for Western medicine and benefits IBS patients globally. Due to the lack of scientific evidence in the past, TCM formulas were not internationally well recognized as promising IBS remedies. In this review, firstly, we present the etiology and therapy of IBS in terms of traditional Chinese medical theory. Secondly, we summarize the clinical randomized controlled trials (RCTs) of TCM formulas for IBS patients that are available in the literature (from 1998 to September 2013), in which 14 RCTs conducted of high quality were discussed in detail. Of the 14 selected trials, 12 of those concluded that TCM formulas provided superior improvement in the global symptoms of IBS patients over the placebo or conventional medicines. As well, all 14 RCTs suggested that TCM formulas have good safety and tolerability. Last but not least, we explore the pharmacological mechanisms of the anti-IBS TCM formulas available in the literature (from 1994 to September, 2013). Collectively, in combating IBS symptoms, most TCM formulas exert multi-targeting actions including the regulation of neurotransmitters and hormones in the enteric nervous system (ENS), modulation of smooth muscle motility in the gastrointestinal (GI) tract, modulation of the hypothalamic-pituitary-adrenal (HPA) axis, attenuation of intestinal inflammation and restoration of intestinal flora, etc. In conclusion, TCM formulas appear to be promising for IBS treatment. This review provides a useful reference for the public in furthering a better understanding and acceptance of TCM formulas as IBS remedies.
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Affiliation(s)
- Hai-Tao Xiao
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China
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Liu CY, Wu WH, Huang TP, Lee TY, Chang HH. A novel model for exploring the correlation between patterns and prescriptions in clinical practice of traditional Chinese medicine for systemic lupus erythematosus. Complement Ther Med 2014; 22:481-8. [DOI: 10.1016/j.ctim.2014.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 03/07/2014] [Accepted: 03/17/2014] [Indexed: 12/24/2022] Open
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Chang CM, Wu WH, Kuo BIT, Lee TY, Liu CY, Chang HH. Using a questionnaire among patient, resident doctor and senior supervisor: Are their answers the same? Complement Ther Med 2014; 22:296-303. [PMID: 24731901 DOI: 10.1016/j.ctim.2014.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/30/2014] [Accepted: 02/23/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study aims to contribute to the development of objective diagnostic standards in Traditional Chinese Medicine (TCM), in order to improve the training of physicians. METHODS We devised a questionnaire study to evaluate the accuracy of resident doctors' diagnostic skills by comparing their assessment of patients with those of their senior supervising physician and the patients themselves. We selected 39 patients with systemic lupus erythematosus (SLE) at Chang Gung Memorial Hospital, Taiwan, between November 1, 2008 and June 30, 2012, and had the resident doctors (R), their senior supervisor (S) and their patients (P) fill out questionnaires before treatment (V1), immediately after treatment (V5) and two months after treatment (V6), in order to record their assessments on the patients' condition. The R and S questionnaires covered subjective symptoms, tongue, and pulse, while the P questionnaires only included general symptoms. We then compared the assessment records to determine the level of agreement between them. RESULTS The agreements of inquiry during the study for P and S were 0.78 (V1) to 0.84 (V6) and 0.87 (V1) to 0.94 (V6) for R and S, respectively, the agreements between R and S for tongue diagnosis and pulse diagnosis were 0.87 (V1) to 0.90 (V6) and 0.91 (V1) to 0.95 (V6), respectively. All the above agreements improved with time from V1 to V6. CONCLUSIONS The results show that the patient input was feasible and effective and that the questionnaire method provided an objective assessment standard to determine how successfully the resident doctor was trained. Furthermore, it facilitated a training process that could help resident doctors improve their skills.
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Affiliation(s)
- Ching-Mao Chang
- Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan.
| | - Wen-Hsiang Wu
- Department of Healthcare Management, Yuanpei University, Hsinchu 30015, Taiwan.
| | - Benjamin Ing-Tiau Kuo
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
| | - Tzung-Yan Lee
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan.
| | - Chia-Yu Liu
- Department of Chinese Medicine, Linsen Chinese Medicine Branch, Taipei City Hospital, Taipei 10453, Taiwan.
| | - Hen-Hong Chang
- Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan; Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan.
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16
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Chang MC, Shapiro D, Joshi A, Shahabi L, Tan S, Smith S, Hui KK, Tillisch K, Mayer EA, Naliboff BD. Stress reactivity in traditional Chinese medicine-based subgroups of patients with irritable bowel syndrome. J Altern Complement Med 2013; 20:276-83. [PMID: 24256027 DOI: 10.1089/acm.2013.0197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study aimed to examine differences in autonomic responses to stress, pain perception, and the role of negative affect in these responses in individuals with irritable bowel syndrome (IBS) according to Traditional Chinese Medicine (TCM) classifications. DESIGN Fifty-nine female patients with IBS age 18-65 years diagnosed by TCM practitioners as showing primarily an excess (n=32) or an overlap (n=27) pattern (mixed excess and deficiency) were assessed for symptom differences, heart rate, and skin conductance responses to a psychosocial stressor and pain perception. SETTINGS/LOCATIONS: University of California in Los Angeles, California. RESULTS Compared with the excess group, the overlap group showed significantly greater overall gastrointestinal symptom severity, abdominal pain, and negative affect. The excess group with higher levels of negative affect showed greater reactivity to stress, whereas the overlap group showed an opposite response pattern. The overlap group showed increased cold sensitivity. CONCLUSIONS IBS patients with the overlap pattern have greater disease severity and comorbidity than those with excess alone. Those with excess showed a pattern of increased stress response with greater negative affect, whereas the overlap group with greater deficiency showed lower physiologic arousal with greater negative affect, consistent with depletion resulting from allostatic load.
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Affiliation(s)
- Megan C Chang
- 1 Department of Occupational Therapy, San Jose State University , San Jose, CA
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17
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Stuardi T, MacPherson H. Acupuncture for irritable bowel syndrome: diagnosis and treatment of patients in a pragmatic trial. J Altern Complement Med 2012; 18:1021-7. [PMID: 23102521 DOI: 10.1089/acm.2011.0670] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the treatments delivered during a pragmatic effectiveness study of acupuncture for irritable bowel syndrome (IBS) and to explore the roles of Traditional Chinese Medicine (TCM) diagnoses and preferences of the acupuncturists in treatment design. METHODS Patients allocated to an acupuncture arm of a study were offered up to ten sessions of acupuncture over 3 months. Acupuncturists followed a flexible treatment protocol that allowed for treatment individualization, use of additional therapies such as moxa, and provision of lifestyle advice. All treatments were recorded in logbooks and analyzed by content analysis. RESULTS Seven primary and eight secondary TCM patterns were identified among the 113 patients with IBS, and were combined in various ways to produce unique diagnoses for 84% patients. Liver Qi Stagnation and Damp Heat were the most commonly reported patterns. Of the 126 acupuncture points used, a distinct core and supporting group of points was associated with each primary pattern. Each practitioner also utilized a distinct core and supporting group of points that reflected his/her preferences. Use of additional therapies (e.g., moxa) and provision of lifestyle advice (e.g., diet) were generally consistent with a particular practitioner. CONCLUSIONS Data suggest that a patient's TCM diagnosis, the practitioner's preferences, and a patient's individual characteristics beyond his/her diagnosis influence treatment delivery. In particular, TCM diagnoses appear to influence the acupuncture (i.e., point selection) aspect of treatment more than the selection of additional therapies and lifestyle advice. From another perspective, the treatments incorporated pragmatic, individualized, and disease-specific approaches with combinations that produced both treatment commonalities and diversities.
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Affiliation(s)
- Tracy Stuardi
- Department of Health Sciences, University of York, York, United Kingdom.
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18
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Zhang L, Yu DL, Wang YG, Zhang QM. Selecting an appropriate interestingness measure to evaluate the correlation between Chinese medicine syndrome elements and symptoms. Chin J Integr Med 2011; 18:93-9. [PMID: 21994028 DOI: 10.1007/s11655-011-0859-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Indexed: 10/16/2022]
Abstract
To select the best interestingness measure appropriate for evaluating the correlation between Chinese medicine (CM) syndrome elements and symptoms, 60 objective interestingness measures were selected from different subjects. Firstly, a hypothesis for a good measure was proposed. Based on the hypothesis, an experiment was designed to evaluate the measures. The experiment was based on the clinical record database of past dynasties including 51 186 clinical cases. The selected data set in this study had 44 600 records. Cold and heat were selected as the experimental CM syndrome elements. Three indicators calculated according to the distances between two CM syndrome elements were obtained in the experiment and combined into one indicator. The Z score, ϕ-coefficient, and Kappa were selected from 60 measures after the experiment. The Z score and ϕ-coefficient were selected according to subjective interestingness. Finally, the ϕ-coefficient was selected as the best measure for its low computational complexity. The method introduced in this paper may be used in other similar territories.
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Affiliation(s)
- Lei Zhang
- Beijing Jiaotong University, Beijing, 100044, China.
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Abstract
'Gut health' is a term increasingly used in the medical literature and by the food industry. It covers multiple positive aspects of the gastrointestinal (GI) tract, such as the effective digestion and absorption of food, the absence of GI illness, normal and stable intestinal microbiota, effective immune status and a state of well-being. From a scientific point of view, however, it is still extremely unclear exactly what gut health is, how it can be defined and how it can be measured. The GI barrier adjacent to the GI microbiota appears to be the key to understanding the complex mechanisms that maintain gut health. Any impairment of the GI barrier can increase the risk of developing infectious, inflammatory and functional GI diseases, as well as extraintestinal diseases such as immune-mediated and metabolic disorders. Less clear, however, is whether GI discomfort in general can also be related to GI barrier functions. In any case, methods of assessing, improving and maintaining gut health-related GI functions are of major interest in preventive medicine.
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Affiliation(s)
- Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr 12, Stuttgart D 70599, Germany.
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20
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Wu MY, Hu TM, Zheng XS. Huangshu Enema down-regulates VIP expression in the colonic mucosa of rats with diarrhea-predominant irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2010; 18:2966-2970. [DOI: 10.11569/wcjd.v18.i28.2966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of Chinese medicine Huangshu Enema (HSE) on the expression of vasoactive intestinal polypeptide (VIP) in the colonic mucosa of rats with diarrhea-predominant irritable bowel syndrome (D-IBS) and to explore possible mechanisms involved.
METHODS: Forty-eight female Sprague-Dawley rats were randomly divided into normal control group, model group, HSE treatment group and dicetel treatment group (n = 12 for each group). D-IBS was induced in rats by intragastric administration of senna decoction and restraint stress. The expression of VIP in the colonic mucosa of rats was determined by immunohistochemistry.
RESULTS: The number of VIP-positive cells and VIP staining intensity in the colonic mucosa of rats were significantly higher in the model group than in the normal control group (21.06 ± 2.69 vs 6.25 ± 2.08, t = 17.4216, P < 0.01; 2.43 ± 0.63 vs 0.63 ± 0.62, t = 6.5223, P < 0.01), in the model group than in the two treatment groups (t = 11.6697 and 5.5119; t = 6.0910 and 2.1575, respectively; both P < 0.01), and in the dicetel treatment group than in the HSE treatment group (10.62 ± 2.36 vs 15.31 ± 2.65, t = 5.2876, P < 0.01; 1.25 ± 0.58 vs 1.93 ± 0.68, t = 2.9272, P < 0.01).
CONCLUSION: HSE can reduce the number of VIP-positive cells and VIP staining intensity in the colonic mucosa of D-IBS rats and thereby exerts therapeutic effects against D-IBS.
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Stuardi T, Atkin K. How Acupuncturists Envision Treating Irritable Bowel Syndrome: A Pre-Trial Analysis. Med Acupunct 2010. [DOI: 10.1089/acu.2009.0726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Tracy Stuardi
- Department of Health Sciences, University of York, York, UK
| | - Karl Atkin
- Department of Health Sciences, University of York, York, UK
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Lembo AJ, Conboy L, Kelley JM, Schnyer RS, McManus CA, Quilty MT, Kerr CE, Drossman D, Jacobson EE, Davis RB. A treatment trial of acupuncture in IBS patients. Am J Gastroenterol 2009; 104:1489-97. [PMID: 19455132 PMCID: PMC2694961 DOI: 10.1038/ajg.2009.156] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to compare the effects of true and sham acupuncture in relieving symptoms of irritable bowel syndrome (IBS). METHODS A total of 230 adult IBS patients (75 % females, average age: 38.4 years) were randomly assigned to 3 weeks of true or sham acupuncture (6 treatments) after a 3-week "run-in" with sham acupuncture in an "augmented" or "limited" patient-practitioner interaction. A third arm of the study included a waitlist control group. The primary outcome was the IBS Global Improvement Scale (IBS-GIS) (range: 1 - 7); secondary outcomes included the IBS Symptom Severity Scale (IBS-SSS), the IBS Adequate Relief (IBS-AR), and the IBS Quality of Life (IBS-QOL). RESULTS Although there was no statistically significant difference between acupuncture and sham acupuncture on the IBS-GIS (41 vs. 32 % , P = 0.25), both groups improved significantly compared with the waitlist control group (37 vs. 4 % , P = 0.001). Similarly, small differences that were not statistically significant favored acupuncture over the other three outcomes: IBS-AR(59 vs. 57 % , P = 0.83), IBS-SSS (31 vs. 21 % , P = 0.18), and IBS-QOL (17 vs. 13 % , P = 0.56). Eliminating responders during the run-in period did not substantively change the results. Side effects were generally mild and only slightly greater in the acupuncture group. CONCLUSIONS This study did not find evidence to support the superiority of acupuncture compared with sham acupuncture in the treatment of IBS.
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Affiliation(s)
- Anthony J Lembo
- The Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rabb/Rose 1, Boston, MA 02215, USA.
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Is the content of the Chinese Quality of Life Instrument (ChQOL) really valid in the context of traditional Chinese medicine in Hong Kong? Complement Ther Med 2008; 17:29-36. [PMID: 19114226 DOI: 10.1016/j.ctim.2008.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 07/08/2008] [Accepted: 07/13/2008] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Content validity is crucial in quality of life instrument development but there is very little literature on this in Chinese culture. The Chinese Quality of Life Instrument (ChQOL) was developed in Mainland China to capture the health-related quality of life (HRQOL) concepts specific to traditional Chinese medicine (TCM). The aim of this study was to evaluate the content validity of ChQOL in a Chinese population whose spoken dialect and health-care system are different from those of Mainland China to find out whether the instrument is generalizable. METHODS 8 TCM practitioners and 10 patients rated the clarity, relevance and appropriateness of each of the 50 items of the ChQOL (HK version), and completed qualitative cognitive debriefing interviews. RESULTS The content of ChQOL was rated valid by TCM practitioners with CVIs on clarity, relevance and appropriateness ranging from 80 to 100%. 49 out of 50 items were well understood by patients, but 12 items had CVI on relevance and 5 items had CVI on appropriateness lower than 70% among patients. After reviewing the patients and TCM practitioners' opinions, revisions were made for three items (2, 8 and 29) to form the ChQOL (HK version)-2008. In general, the ChQOL was found to be too long which called for shorter version. CONCLUSIONS The content of ChQOL was shown to be really valid in the context of Chinese Medicine for Cantonese speaking Chinese. There was some discrepancy between the judgments of TCM practitioners and patients indicating the importance of evaluation by both experts and lay persons.
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Affiliation(s)
- J E Kellow
- Department of Gastroenterology, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia.
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Lee S, Park J, Lee H, Kim K. Development and validation of Yin-Deficiency Questionnaire. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2007; 35:11-20. [PMID: 17265546 DOI: 10.1142/s0192415x07004576] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study describes development and validation of a questionnaire as an adjunct to Traditional Chinese Medicine diagnosis of Yin-Deficiency Syndrome (Yin-DS). The Yin-Deficiency Questionnaire 1 (Yin-DQ1) consists of 10 items. Seventy-nine healthy volunteers and 44 patients diagnosed with Yin-DS were enrolled for the evaluation of discriminant validity and factorial validity. Another group of 83 healthy volunteers participated for test-retest reliability test. Internal consistency was high in both groups (Cronbach's alpha = 0.8615). Test-retest reliability (Spearman's rank correlation coefficient) ranged from 0.54 to 0.79 (p < 0.01). Factor analysis demonstrated that a two factor solution best explained the variance in responses (51.62%). The scores of all items in patients diagnosed with Yin-DS were significantly higher compared with those of healthy volunteers. The data show the internal consistency, test-retest reliability and strong discriminative properties of the Yin-DQ1. Further research determining the optimal cut-off score for Yin-DS and testing its usage as an outcome measure in a clinical trial is needed.
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Affiliation(s)
- Sangjae Lee
- Institute of Korean Medicine for Healthy Living, Seoul, South Korea
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26
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Tong-xie-ning, a Chinese herbal formula, in treatment of diarrhea-predominant irritable bowel syndrome: a prospective, randomized, double-blind, placebo-controlled trial. Chin Med J (Engl) 2006. [DOI: 10.1097/00029330-200612020-00015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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27
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Leung WK, Wu JCY, Liang SM, Chan LS, Chan FKL, Xie H, Fung SSL, Hui AJ, Wong VWS, Che CT, Sung JJY. Treatment of diarrhea-predominant irritable bowel syndrome with traditional Chinese herbal medicine: a randomized placebo-controlled trial. Am J Gastroenterol 2006; 101:1574-80. [PMID: 16863563 DOI: 10.1111/j.1572-0241.2006.00576.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND As there is no effective treatment for irritable bowel syndrome (IBS), many patients turn to traditional Chinese medicine (TCM) for possible cure. We investigated the therapeutic efficacy of an ancient herbal Chinese formula in patients with diarrhea-predominant IBS. METHODS This was a randomized double-blinded placebo-controlled trial. Chinese IBS patients with predominant diarrhea symptoms that fulfilled Rome II criteria were recruited. The diagnosis was verified by a TCM herbalist using TCM criteria. Eligible patients were randomized to receive a standard preparation of TCM extracts that contained 11 herbs or placebo with similar appearance and taste for 8 wk after a 2-wk run-in period. Patients were followed up for an additional 8 wk post-treatment. Primary outcome was patient's global symptom assessment. Other outcome measures included individual IBS symptom scores and health-related quality of life (short form 36). RESULTS One hundred nineteen patients were randomized: 60 to receive TCM and 59 to receive placebo. There was no significant difference in the proportion of patients with global symptom improvement between the TCM and placebo groups at week 8 (35% vs 44.1%, p = 0.38) and at week 16 (31.7% vs 33.9%, p = 0.62). Moreover, there was no difference in individual symptom scores and the quality-of-life assessment between the two groups at all time points. BACKGROUND The use of this herbal formulation for diarrhea-predominant IBS did not lead to global symptom improvement. Further controlled clinical studies may be necessary to characterize the role of TCM in the management of IBS.
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Affiliation(s)
- Wai K Leung
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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