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Research direction for syndromes of traditional Chinese medicine: differentiating diseases from syndromes and differentiating syndromes from diseases  [cached]
Qiao-Chu WANG
Zhong Xi Yi Jie He Xue Bao , 2006,
Abstract: By historical review on integrative research of syndrome differentiation and disease differentiation and considering the scientific research method of traditional Chinese medicine (TCM), the syndrome is the key subject of clinical study on TCM. During the recent 10 years or more, many new diseases and diagnostic approaches have been found and developed in Western medicine, while in TCM, the advances in research on syndrome can not keep up with the requirements of clinical practice. This problem was caused by three matters as follows: (1) Syndrome differentiation and its classification have been conservative and lack of new discovery; (2) The thinking pattern of clinical practice has been focused on disease differentiation, and only complemented by syndrome differentiation; (3) The treatment has been concentrated on the disease instead of on the syndrome. Considering these problems, the author has put forward the thinking pattern of clinical research, that is "to differentiate diseases from syndromes and to differentiate syndromes from diseases". In this way, many new syndromes and diseases will be discovered with the improvement of disease and syndrome differentiations. These advances will provide rich resources for basic theoretical and pharmacal studies of TCM, and improve the common understanding of TCM in the world.
Correlation between traditional Chinese medicine syndromes and omics: a literature review
Shuo Zhang,Hong-cai Shang
Zhong Xi Yi Jie He Xue Bao , 2011,
Abstract: As the post-genome era is approaching, omics has become a hot topic in the research field of life sciences and is also widely used in traditional Chinese medicine (TCM) research. For discussing the correlation between syndromes and omics, the authors explored the application of genomics, proteomics and metabonomics in the study of syndrome classification from the macroscopic view, after a systematic and normative study of the literature. The authors drew the conclusion that research into the correlation between syndromes and omics has great clinical significance in terms of the scientific application and quantification of TCM treatment based on syndrome differentiation.
Characteristics of traditional Chinese medicine syndromes in post-stroke depression  [cached]
Hui HAN
Zhong Xi Yi Jie He Xue Bao , 2010,
Abstract: Objective: To explore the main characteristics of syndromes in traditional Chinese medicine (TCM) in post-stroke depression (PSD) and to provide basis for treatments with TCM herbs.Methods: According to diagnostic criteria of PSD, stroke patients and depression patients from Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine were assigned into cerebral stroke group (150 cases), depression group (151 cases) and PSD group (123 cases). Neuropsychological assessments and imaging and biochemical analyses were conducted. TCM syndrome differentiation for these diseases was performed. We also determined the characteristics of TCM syndromes of PSD, relative risk of the syndromes and their correlations with ages as well.Results: Scores of qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation in PSD group were significant higher than those in cerebral stroke group (P<0.05, P<0.01). In cerebral stroke group, majority of the patients displayed one syndrome, while in PSD and depression groups, the patients had three or more syndromes. Of these syndromes, the incidence rate of syndrome of liver qi depression complicated with transformation of fire due to qi stagnation or flaring of fire due to yin deficiency was high. The syndrome of liver qi depression occurred much more frequently in PSD group and depression group than in cerebral stroke group (P<0.05, P<0.01). The logistic regression analysis showed that the syndrome of qi stagnation and blood stasis had high relative risk to PSD. The syndrome of deficiency of heart and spleen was positively correlated with age in cerebral stroke group.Conclusion: The main TCM syndromes of PSD and depression are qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation. The syndrome of deficiency of heart and spleen is closely related to age among the stroke patients. The syndrome of qi stagnation and blood stasis serves as an independent risk factor for PSD. The more complicated the syndromes are, the more serious depression becomes.
A study of diagnostic criteria for traditional Chinese medicine syndromes in osteoporosis
Dong-tao Li
Zhong Xi Yi Jie He Xue Bao , 2011,
Abstract: Objective: To establish diagnostic criteria for common traditional Chinese medicine (TCM) syndromes in osteoporosis. Methods: Based on the collection and analysis of related medical literature, clinical investigation, and expert discussion, a draft of preliminary diagnostic criteria for the basic syndromes of TCM in patients with osteoporosis was formulated. Then it was used in clinic for verification and revised repeatedly until a formal version of diagnostic criteria was satisfactorily achieved.Results: The basic syndromes listed in the diagnostic criteria for patients with osteoporosis consisted of two parts: qualitative diagnosis and localization diagnosis. Results of qualitative diagnosis showed that the qualitative syndromes included damage of essence, deficiency of vital energy, deficiency of yin, deficiency of yang and blood stasis. The localization diagnosis showed that location of osteoporosis is bone and corresponds to the kidney, and also involves liver, lung, spleen (stomach) and heart. The diagnostic content has established the specific symptoms and the non-specific symptoms during various stages. Each of the above syndromes could be diagnosed according to a specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio of qualitative diagnosis was 80.56% between the diagnoses made according to the criteria and the diagnoses acquired from the experts' experience, and the total matching ratio of localization diagnosis was 85.56%.Conclusion: The TCM syndrome diagnostic criteria for osteoporosis is generally consistent with TCM clinical practice, worthy of further popularization and application in clinical practice.
Functional Somatic Syndromes: Emerging Biomedical Models and Traditional Chinese Medicine  [PDF]
Steven Tan,Kirsten Tillisch,Emeran Mayer
Evidence-Based Complementary and Alternative Medicine , 2004, DOI: 10.1093/ecam/neh016
Abstract: The so-called functional somatic syndromes comprise a group of disorders that are primarily symptom-based, multisystemic in presentation and probably involve alterations in mind-brain-body interactions. The emerging neurobiological models of allostasis/allostatic load and of the emotional motor system show striking similarities with concepts used by Traditional Chinese Medicine (TCM) to understand the functional somatic disorders and their underlying pathogenesis. These models incorporate a macroscopic perspective, accounting for the toll of acute and chronic traumas, physical and emotional stressors and the complex interactions between the mind, brain and body. The convergence of these biomedical models with the ancient paradigm of TCM may provide a new insight into scientifically verifiable diagnostic and therapeutic approaches for these common disorders.
Pondering on the diagnosis and treatment criteria for syndromes of epilepsy in traditional Chinese medicine  [cached]
Jin-Min LIU
Zhong Xi Yi Jie He Xue Bao , 2006,
Abstract: International League Against Epilepsy announced the new International Classification of Epilepsy in 2001. One of the main objectives of the project is to adopt standard terms to describe seizure phenomena according to the terminological database. The project may profit academic communication and resource integration, and provide evidence for the individual treatment for epilepsy. Treatment based on syndrome differentiation is one of the characteristics of the treatment for epilepsy in traditional Chinese medicine (TCM). As far as the individuation on diagnosis and treatment is concerned, TCM and Western medicine present to reach the same goal by different routes gradually for the treatment of epilepsy. But for TCM, the diagnosis and treatment criteria for epilepsy are imperfect and the experts, opinions are not unified, so that the treatment based on syndrome differentiation becomes confused, hence the credit of treatment based on TCM is restricted accordingly. It is necessary to formulate advanced diagnosis and treatment criteria for syndromes of epilepsy in TCM.
Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis
Dong-tao Li
Zhong Xi Yi Jie He Xue Bao , 2012,
Abstract: OBJECTIVE: To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.METHODS: Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature.The symptoms and sighs were quantitatively classified into three, two or one category according to a 100-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then “Hall for Workshop of Metasynthetic Engineering” expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire.RESULTS: Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire (1 760 cases), and 1 545 of them were filled in completely. Experts’ opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%.CONCLUSION: The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.
Study of a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer
LING Chang-Quan
Zhong Xi Yi Jie He Xue Bao , 2005,
Abstract: Objective: To work out a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer. Methods: Based on the collection and analysis of related medical literature, clinical investigation, and experts’ discussion, a preliminary qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer was formulated. Then it was used in clinic to be verified and revised repeatedly till it was improved to be a satisfied formal criterion. Results: The basic syndromes listed in the qualitative diagnostic criterion for basic syndromes in patients with primary liver cancer consisted of two parts: excessive syndromes, including the syndromes of stagnation of qi, blood stasis, excess-heat and dampness, and deficient syndromes, including the syndromes of deficiency of qi, deficiency of blood, deficiency of yin and deficiency of yang. Each of the above syndromes could be diagnosed according to specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio was 73.92% between the diagnoses made according to the criterion and the diagnoses acquired from the experts’ experience. Conclusions: The qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer is coincident with the experts’ clinical practice. However, it needs to be further studied.
Distribution characteristics of traditional Chinese medicine syndromes and their elements in people with subhealth fatigue
Tian-fang WANG
Zhong Xi Yi Jie He Xue Bao , 2010,
Abstract: Objective: To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in people with subhealth fatigue.Methods: The TCM symptoms in line with the diagnostic criteria of subhealth fatigue status were collected by clinical investigations and using information collection form based on TCM four diagnostic methods. Referred to Clinical Guidelines of Chinese Medicine on Subhealth and other related standards, the syndrome type was identified in accordance with clinical symptoms of each patient with subhealth fatigue by two physicians. The data of syndrome differentiation were analyzed by descriptive statistical analysis.Results: There were 81 syndrome types from 495 cases of subhealth fatigue. There were 24 syndrome types after separation, and the top ten were liver stagnation and spleen deficiency, stagnation of liver qi, hyperactivity of liver fire, disharmony between liver and stomach, damp obstruction due to spleen deficiency, deficiency of both heart and spleen, yin deficiency of liver and kidney, yang deficiency of spleen and kidney, stagnation of gallbladder and disturbance of phlegm, and internal disturbance of phlegm-heat. There were 17 syndrome elements, including seven disease location elements and ten disease nature elements. The disease location elements were liver, spleen, kidney, stomach, heart, gallbladder and lung. The disease nature elements were qi stagnation, qi deficiency, exuberance of fire (heat), damp obstruction, phlegm obstruction, yin deficiency, adverse flow of qi, yang deficiency, blood deficiency, and blood stasis.Conclusion: Syndrome types of subhealth fatigue involve in deficiency syndrome, excess syndrome, and mixture of deficiency and excess syndromes. The syndrome elements of disease location involve five zang organs and two fu organs, and the liver and spleen were the most frequently involved organs. The syndrome elements of disease nature involve deficiency and excess. Qi stagnation is most frequently involved in the excess syndrome, and qi deficiency is most frequently involved in the deficiency syndrome.
A family survey of syndromes of traditional Chinese medicine in patients with β-thalassemia
Wen-juan WANG,Zhi-kui WU
Zhong Xi Yi Jie He Xue Bao , 2009,
Abstract: Objective: To explore the relationship between syndromes of traditional Chinese medicine (TCM) and genetic background in patients with β-thalassemia.Methods: TCM syndromes were surveyed in the selected 78 patients with β-thalassemia intermedia including 120 parents. The gene mutations were detected separately. The frequency and score of TCM syndromes between the offspring and their parents in different family types were analyzed, and the differences were compared.Results: The 73 families were divided into two family types by hereditary characteristics. Family type one meant that genotypes of one of the parents were normal, while the offspring genotypes were heterozygous and were exactly the same as another parent. In the 22 families of type one, the heterozygous offspring manifested 6 high-frequency symptoms and signs such as spontaneous perspiration, dry mouth and dry throat, pale or sallow complexion, tidal fever and night sweating, lassitude and pale fingernails. The heterozygous parents manifested 5 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, aversion to cold and cold limbs, tinnitus, dry mouth and dry throat. The normal parents manifested 3 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, and spontaneous perspiration. TCM syndrome score in the heterozygous offspring was higher than that in the heterozygous and normal parents, but there was no significant difference (P>0.05). Family type two meant that genotypes of both parents were heterozygous, while the offspring genotypes were heterogenic duplex heterozygotes. In the 51 families of type two, the offspring manifested 9 high-frequency symptoms and signs such as pale or sallow complexion, spontaneous perspiration, dry mouth and dry throat, pale fingernails, tidal fever and night sweating, lassitude, frequent attack of common cold, dysphoria with feverish sensation in chest, and yellow discoloration of the skin and sclera. The parents manifested 3 high-frequency symptoms and signs such as lassitude in loins and knees, dizziness, aversion to cold and cold limbs. TCM syndrome score in the offspring was significant higher than that in the parents (P<0.01).Conclusion: In the two family types, TCM syndrome in the offspring is of yin-blood deficiency, while the syndrome of the parents is of kidney deficiency. The differences of TCM syndromes between the offspring and the parents may have some relations to the type of mutant genes and genetically modified ingredients. This research provides scientific evidence to TCM syndrome differen
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