Search

Objectives: Chinese medicine is a complex domain of theoretical and practical approaches that is being increasingly put under the research spotlight. The "Chinese Medicine in Australia"research project attempted to capture the clinical features of practitioners of Chinese medicine. Participants and Interventions: The project involved a national survey of Chinese medicine professional association members and registered practitioners in the state of Victoria, Australia (n = 655; response rate, 42%-55%) completed in 2012-2013. Design: The content and face validated survey was developed using new and previous workforce survey questions. Results: This paper reports on the workforce and practice characteristics of the survey respondents. Chinese medicine practitioners are highly educated, come from diverse backgrounds, and have chosen to practice predominantly in sole or multipractitioner private practice settings. An interest in the philosophy of Chinese medicine and previous experiences contributed to practitioners' decisions to study and practice Chinese medicine. Incorporating a variety of techniques, practitioners describe themselves as practicing predominantly Chinese acupuncture and herbal medicine. Conclusions: The results from this survey contribute to the understanding of the nature and description of Chinese medicine practice in Australia. [ABSTRACT FROM AUTHOR]

Research into the effects of medical interventions is one of the oldest traditions of any medicine, as is the study of its ethical dimension. In this paper, we briefly describe and recount the history of both quantitative and qualitative methods in clinical research. We discuss key theoretical, methodological and practical features of both methodological perspectives and consider some of the central ideas of medical ethics. We sketch a theory of the relationship between the quantitative and qualitative as essentially complementary and interdependent. The theory is illustrated by reference to the placebo effect and a research 'case study' from within the Chinese medicine community. We conclude that despite the challenges, combined research methodologies in Chinese medicine offer both scientific and ethical benefits. [ABSTRACT FROM AUTHOR]

Background: Toyohari meridian therapy (TMT) is a Japanese system of acupuncture. Acupoint selection follows diagnosis of the primary and secondary patterns of disharmony ( sho) and disturbances in the yang channels. Pulse diagnosis and abdominal palpation diagnosis are the two main diagnostic methods used. Little is known about the reliability of pulse, abdominal, and pattern diagnosis in TMT. This is important since diagnosis of the sho determines acupoint treatment. If diagnosis is unreliable, there can be less confidence that the patient will receive optimal treatment. Objective: The objective of this study is to assess the level of agreement between two TMT practitioners on pulse diagnosis, abdominal diagnosis, and diagnosis of the primary and secondary sho. Methods: An inter-rater reliability study was conducted. Two (2) TMT practitioners separately conducted a TMT examination and completed an assessment form, choosing from a range of possible responses relating to pulse characteristics, abdominal diagnosis, and diagnosis of primary sho and secondary sho. The κ coefficient was used as a measure of inter-rater reliability of the outcome variables. Results: Sixty-two (62) Australians (22 males, 40 females) aged 20–65 years participated (mean age 49.2 ± 12.2 years). Level of agreement for pulse diagnosis was 57%, 61%, and 77% for pulse depth, speed, and strength, respectively. For abdominal diagnosis, the level of agreement for involvement of the Lung, Kidney, Spleen, and Liver abdominal regions was 58%, 53%, 35%, and 10%, respectively. The overall level of agreement on primary sho diagnosis was 48% and for secondary sho diagnosis, 44%. Conclusions: Overall, there was a reasonable level of agreement on basic pulse characteristics and on abdominal diagnosis for two of the abdominal regions. Level of agreement on primary and secondary sho diagnosis suggests room for improvement. Further studies are required in order to gain a greater understanding of the reliability of diagnosis in TMT. [ABSTRACT FROM AUTHOR]

The question of the objectivity of the clinical examination has been raised in relation to Western and non-Western medical systems. Western practitioners are often skeptical about Traditional Chinese Medicine (TCM), on the basis that its diagnostic variables and subcategories of disease appear subjective and not repeatable. We conducted a study investigating the reproducibility of individual diagnostic observations within three of the four diagnostic methods used in a TCM examination: inspection, palpation, and auscultation. Three TCM practitioners participated in the study, and examined 45 adults who had mild-to-moderate hypercholesterolemia but were otherwise healthy. Results indicated that while there are certain features of the TCM system that are highly objective and repeatable, such as detection of the presence of shen, character of breath sounds, and pulse speed, there are other features that are subjective and unreliable, such as color under the eyes and tongue body color. This poses a challenge for TCM practitioners to improve their clinical practice and demonstrates to Western medical practitioners that TCM does in part rest on a rigorous and objective empirical basis. [ABSTRACT FROM AUTHOR]

Background: Chinese medicine distinguishes itself from Western medicine in the differentiation of diseases according to underlying patterns of disharmony, or Chinese medicine (CM) syndromes. CM has its own clinical endpoints that are used as evidence of change in the body. Yet, relatively little is known about the reliability of CM diagnostic techniques, the final diagnosis of a CM syndrome, or the organizing principles used to reach a CM diagnosis such as the Eight Guiding Principles. Information about reliability of CM diagnosis has important implications for clinical practice and research, particularly if CM diagnostic variables or CM syndromes are to be incorporated into study designs. Design: An inter-rater reliability study was conducted with three CM practitioners to investigate the reproducibility of CM diagnosis according to the Eight Guiding Principles and Zang-Fu Theory. Forty-five (45) adults with mild hypercholesterolemia but who were otherwise healthy participated in the study. Results: Our results suggest that there is a reasonably good level of agreement between at least two practitioners on the dimensions of the Eight Guiding Principles. Level of agreement between at least two practitioners on CM syndrome diagnosis according to Zang-Fu Theory was very good for one syndrome only, that of Spleen qi deficiency. Conclusions: Further investigations are needed into the reliability of the CM diagnostic processes from the initial stage of data collection to the final CM syndrome diagnosis. [ABSTRACT FROM AUTHOR]

1. The use of traditional Chinese medicinal herbs or their pharmaceutical products for disease prevention and management is becoming increasingly popular in Western countries. Mixtures of various Chinese herbs have been used for the treatment of syndromes clinically overlapping Western cardiovascular syndromes. One modern preparation, known as the ‘Cardiotonic Pill’ (CP), is a pharmaceutical product derived mainly from a medicinal herb, Salvia miltiorrhiza bunge, and recently widely used in Chinese hospitals for the prevention and management of ischaemic cardiovascular diseases. Although the CP is believed to confer an extensive range of benefits, little is known about the physiological actions of this medicine, particularly at the cellular and molecular levels. Therefore, the aim of the present study was to explore possible cellular mechanisms of the CP on the cardiovascular system. 2. Cultured human vascular endothelial cells (EC) and vascular smooth muscle cells (VSMC) were exposed to the CP at various concentrations for periods ranging from hours to days. Cellular DNA synthesis was determined by a [3H]-thymidine incorporation assay, proliferation and death were assessed by investigations of cell numbers and apoptosis, whereas the expression of extracellular adhesion molecules was analysed by flow-cytometry and Western blotting. 3. The CP extract at concentrations of less than 200 µg/mL was not associated with cell damage. At doses beyond the therapeutic range (10–20 µg/mL), the CP appeared to exert a mild inhibitory effect on DNA synthesis and proliferation of EC in serum-enriched cultures. The CP significantly attenuated tumour necrosis factor-α-induced expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in a dose-dependent manner, with 50 and 100 µg/mL CP producing decreases in the expression of ICAM-1 of 26–32% and 32–44%, respectively, and of VCAM-1 of approximately 23% and 27–42%, respectively. The CP did not affect apoptosis in EC under conditions of serum-deprivation. 4. In VSMC, the CP significantly inhibited platelet-derived growth factor BB-induced DNA synthesis and cell proliferation in a dose-dependent manner. The CP did not affect VSMC expression of adhesion molecules. 5. We conclude that the CP inhibits expression of ICAM-1 and VCAM-1 in EC and proliferation of VSMC in a manner that has potentially beneficial therapeutic effects. [ABSTRACT FROM AUTHOR]

Abstract: Background: Danshen (DS, Salvia miltiorrhiza), Shanchi (SQ, Panax notoginseng), Shanzai (SZ, Hawthorn) and Heshouwu (HSW, Polygonum multiflorum Thunb) are four medicinal herbs commonly used in traditional Chinese medicine and previously shown to have activity that may contribute to cardiovascular protection. This study aims to investigate effects of these herbs on vascular endothelial cells with respect to cell viability and expression of cellular adhesion molecules under inflammatory conditions. Methods: Herbal extracts were prepared by an established industrial manufacturing process. Human umbilical vein endothelial cells (HUVEC) were incubated with the herbal extract under normal or serum-free culture and tumor necrosis factor (TNF) α stimulation. Cell apoptosis, apoptosis-associated gene expression, expression of cellular adhesion molecules, DNA synthesis, and growth were assessed via morphological examination, Annexin-V staining, Western blotting analysis, Flow-Cytometry, [3H]-thymidine incorporation assay, and cell number study. Results: SZ and HSW significantly inhibited apoptosis in HUVEC undergoing serum deprivation and TNFα stimulation, accompanied by down-regulation of caspase-3 gene expression. DS and SQ significantly attenuated TNFα-induced expression of adhesion molecule VCAM-1 and also ICAM-1 by DS in the cells. All four herbs at therapeutic concentrations (100 μg/mL) inhibited DNA synthesis (10–42% decrease in [3H]-thymidine incorporation rates) and growth (5–10% decrease in cell numbers) in HUVEC under normal cultures. Conclusion: DS, SQ, SZ and HSW are physiologically active on human vascular endothelial cells. The actions by HSW and SZ to reduce apoptosis and DS and SQ to inhibit adhesion molecule expression may help protect endothelial function and inhibit atherogenesis, while their actions to inhibit DNA synthesis and cell growth may weaken the ability of endothelial repair. Further studies are needed to identify the chemical compounds responsible to these physiological effects by these herbs. [Copyright &y& Elsevier]