Résumé
Screening and evaluating the diseases responding specifically to traditional Chinese medicine (TCM) will help to highlight the advantages of TCM treatment, and the evaluation method should be standardized with consideration to the unique characteristics of the diseases. The incidence of Sjögren's Syndrome (SS) is increasing year by year, while the pathogenesis of this disease remains unclear. Modern therapies for this disease include biological agents and immunosuppressants, which generally have unsatisfactory efficacy. The TCM treatment of SS focuses on the harmony of the physical and mental health. The Rheumatology Branch of the China Association of Chinese Medicine organizes experts in TCM, Western medicine, and evidence-based medicine to form working groups. Delphi method and bibliometric method were used for analysis, and SS was selected as a disease responding specifically to TCM. Furthermore, the evaluation system was established for this disease, and the consensus regarding this disease was reached after seminar discussion. This paper summarized the whole process of the evaluation of the advantages of TCM treatment of SS. First, because TCM atomization is widely used in clinical practice and enriches TCM administration methods, this therapy is included after other non-drug therapies were taken as characteristic therapies. Second, the evaluation indicators of therapeutic effect should be determined with consideration to international acceptance and the current research status. Third, the expression method should be accurate, standardized, and objective, highlight the natural advantages of TCM, and avoid arbitrary extension. This paper provides a reference for clinicians to explore other diseases responding specifically to TCM.
Résumé
Sjögren's syndrome (SS), a disorder of immune system, is one of the dominant diseases treated by traditional Chinese medicine (TCM). China Association of Chinese Medicine organized experts in the field of TCM and western medicine rheumatology and pharmacology to discuss the advantages and optimal regimens of TCM for the treatment of SS. The experts generally agreed on the low early diagnosis rate of SS and the lack of targeted therapeutic drugs. In addition, autoimmune abnormality is the key factor in the occurrence of SS and deficiency of both Qi and Yin is the core pathogenesis. SS has unique tongue manifestations, which is expected to allow for the early diagnosis and treatment with integrated traditional Chinese and western medicine. TCM has advantages in treating SS in terms of alleviating clinical symptoms and systemic involvement, individualized treatment, relieving sleep and mood disorders, preventing the occurrence in the early stage, and enhancing the effectiveness and reducing toxicity in the treatment by integrated TCM and western medicine. In general, TCM has advantages in different stages of SS. Internal and external use of TCM, acupuncture, and acupotome are all available options. The optimal regimens should be determined on the basis of pattern identification, stage of disease, and the advantages of TCM. Clinical characteristics and biomarkers of SS should be studied to classify patients, so as to design precision evidence-based TCM regimens for SS. On the basis of unique tongue manifestations of SS, models for early diagnosis and poor prognosis identification of SS should also be established to achieve early prevention and treatment and to improve the prognosis. In the future, we should vigorously carry out high-quality evidence-based medical research on the treatment of SS by TCM and integrated traditional Chinese and western medicine and develop relevant guidelines to optimize and standardize current diagnosis and treatment, thereby laying a basis for clarifying and explaining the advantages of TCM in treating SS.
Résumé
The pathogenesis of Sjögren's syndrome (SS) was considered to involve external dryness, internal injured essence and blood, yin-deficiency endowment, and abnormal emotion and spirit, and it was believed that SS has the characteristics of dryness and impassability, and the pathogenesis of deficiency-excess in complexity. According to the theory “upper dryness treats qi, and lower dryness treats blood” in YE Gui's monograph “Medical Records for Clinical Guidance”, the dryness was divided into upper dryness and lower dryness syndromes to be differentiated and treated. When treating dryness syndrome, the patient should follow the characteristics of the five zang organs, using soft and cool medicines, avoiding warm and dry medicines, and valuing the animal products. The upper dryness could be treated with Sangxiang Decoction (桑杏汤) to clear the qi and moisten the dryness, Qiaohe Decoction (翘荷汤) to clear the upper with pungent-cool, and Shashen Maidong Decoction (沙参麦冬汤) to nourish yin and promote the production of body fluid. The lower dryness could be treated with Fumai Decoction (复脉汤) to enrich and nourish the five kinds of fluid. Liuwei Dihuang Pill (六味地黄丸) to nourish the kidneys and supplement essence, and Wuren Pill (五仁丸) to moisten the dryness and nourish the blood, which provided a new way of thinking for differentiation of the dryness syndrome.
Résumé
ObjectiveTo analyze the complaints of outpatient of Guang’anmen Hospital, China Academy of Chinese Medical Sciencse, discuss the countermeasures to alleviate the contradiction and promote the normalization of the relationship between doctors and patients.Methods Based on analysis of outpatient complaints from Jan. 2008 to Dec. 2012 in our hospital, statistics and classification data were obtained from the aspects of service attitude, medical errors, process and communication.ResultsOutpatient amount of our hospital form Jan. 2008 to Dec. 2012 was 10.55 million. There were 1426 outpatient complaints (service attitudes 24.2%, medical errors 11.5%, process 40.3%, and communication 24%), etc. Complaints rate was 0.135‰ and satisfaction degree of dealing with complaints was 99.3%.Conclusion Through active service, the complaints of outpatients has been reduced, and diagnostic and treatment quality and satisfactory degree have been increased of our hospital.