Research Capacity at Traditional Chinese Medicine (TCM) Centers in China: A Survey of Clinical Investigators.

Background. The development of an evidence-based approach to traditional Chinese medicine (TCM), which depends on the generation of good quality evidence, requires an adequate workforce. However, the research capacity of TCM investigators is not known. Study Design. This cross-sectional study was conducted to describe the research capacity of TCM clinical investigators in China. Participants. A total of 584 participants from TCM hospitals and research centers were included. They were asked about the academic and research characteristics, needs for research capacity building, and barriers to clinical research. Results. The majority (80.82%) were qualified to at least a Master's degree, whilst a smaller proportion (40.24%) held a senior professional title. We found that academic outputs were low with the majority (62.16%) authoring less than five publications in total. The most pressing needs for building research capacity identified were training in research methodology (97.43%) and identification of research questions (86.81%), whilst the highest ranking barriers to conducting research were limited motivation, funding (40.72%), and time (37.15%). Conclusion. The methodology training, along with investment in the research workforce, needs to be urgently addressed to improve investigators' research capacity and the development of an evidence-based approach of TCM.

[Survey and analysis of circulation and cultivation of medicinal plants in Tangchang county].

The article sort out the main planting information of Chinese medicinal materials in Tanchang county from 2012 to 2014, through doing a questionnaire survey, setting technical training and communicating with people who plant, process, and sell the Chinese medicinal materials in the main producing area in 25 villages and towns of Tanchang county. By analyzing the results, the author pointed out the current situation of Chinese medicinal material planting, processing, trading and also the existing problems, and gave a proposal and strategy to the industrial development of Chinese medicinal materials, therefore, set an example to the development of the county territory.

[Discussion on solutions to ethical issues of clinical researches in a real world].

The paradigm of a real world study has become the frontiers of clinical researches, especially in the field of Chinese medicine, all over the world in recent years. In this paper, ethical issues which probably exist in real-world studies are raised and reviewed. Moreover, some preliminary solutions to these issues such as protecting subjects during the process of real-world studies and performing ethical review are raised based on recent years' practices to enhance the scientificity and ethical level of real-world studies.

[Establishment and implementation of evidence-based clinical pathway of Chinese medicine].

The purpose of establishing an evidence-based clinical pathway is to standardize the clinical practice, improve the quality of health care and cure patients' illness. Since the core of evidence-based medicine (EBM) lies in implementing the current best available evidence of clinical research to direct the decision making in clinical practice, evidence obtained from research should be kept to either in formulating a clinical practice guideline or establishing a clinical pathway. The EBM method for establishing clinical pathway was introduced in this paper, including setting up a compilation team, raising clinical relevant problems, searching and critically appraising available evidence, and incorporating them into the process of clinical pathway establishment, expecting to provide methodological guidance for establishing TCM clinical pathway in future.

[Guidelines for evidence-based Chinese medicine clinical pathway report].

Clinical pathway (CP), as a standardized approach and clinical management process for disease diagnosing and treating, is being widely used with more relevant publications reported gradually. But different forms of CP reports may prevent the evaluation and spreading of CP. The authors recommend guidelines for evidence-based Chinese medicine CP report, including 18 items which form 5 big sections, by precise item selection and rigorous expert consensus. All these items can embody the principles of Chinese medicine and comply with the requirements of the clinical practice of Chinese medicine. All above are based on synthesizing the published literature systematically and analyzing the current status in this field, also according to the characteristics of Chinese medicine and methodology requirement of evidence-based medicine.

[Theoretical basis and application of evidence-based clinical pathway of Chinese medicine].

Based on the principle of management, evidence-based medicine, operational research and health economics, this essay addressed the theoretical basis of clinical pathway and its application of evidence-based Chinese medicine to practice. It could be taken as references for different health care institutions and organizations for development of clinical pathway.

[Key issues on the clinical pathway development: a view from Chinese medicine and integrative medicine].

Comparing with the Western medicine, the clinical pathway development of Chinese medicine (CM)/integrative medicine (IM), on one hand, should follow the basic principles of general clinical pathway; on the other and prior hand, it ought to coordinate with the rule of CM, and display sufficiently the advantages of CM based upon the evidences. Several key issues which may be encountered in the development and the relevant strategies were introduced in this paper.

[Effect of moxibustion in treating knee joint osteoarthritis and its relation with contents of hyaluronic acid in serum and synovial fluid].

OBJECTIVE: To investigate the clinical effects of moxibustion (Mox) in treating knee joint osteoarthritis, and to detect the change of hyaluronic acid (HA) level in serum and synovial fluid (SF) for evaluating its significance. METHODS: Thirty OA patients were treated with Mox applied on inner and outer hsiyens and Ashi point for 10 min once a day, 5 times a week for 3 months and the therapeutic efficacy was evaluated. Serum and SF levels of HA were measured by radio-immunoassay before and after the 3-month treatment, and compared with those from 30 non-OA persons for normal control. RESULTS: After treatment, 19 patients (20 joints) out of the 30 patients were cured, the efficacy of Mox was evaluated as markedly effective in 8 patients on 10 joints, and as effective in 3 patients on 4 joints, the cure rate being 63.3%. Before treatment, HA level in serum (122.87 +/- 34.10 microg/L) was higher and in SF (0.98 +/- 0.17 g/L) was lower in OA patients than those in the normal controls (68.32 +/- 21.48 microg/L and 1.62 +/- 0.30 g/L, P<0.01), whereas after treatment, both the serum and SF levels of HA in patients changed toward normal range (70.29 +/- 27.30 microg/L and 1.58 +/- 0.26 g/L), showing insignificant difference as compared with those in the controls (P<0.01). CONCLUSION: Mox is an effective approach for treatment of OA, and the levels of HA in serum and SF can be taken as the quantitative indicators for evaluating the pathogenetic condition of OA patients.

[Controlled clinical trials of initial observation on therapeutic effects of moxibustion for osteoarthritis of the knee: multi-center clinical effect].

OBJECTIVE: To compare therapeutic effects between moxibustion and infrared therapy for the treatment of knee osteoarthritis. METHODS: From January 2007 to June 2008 period, 65 patients with knee osteoarthritis were divided into treatment and control groups randomly uniform random number table generated from SAS statistical software. Among 35 patients in the treatment group, 17 patients were male and 18 patients were female, ranging in age from 45 to 75 years, with an average of (61.2+/-6.4) years; the course of disease ranged from 9 to 43 months, with a mean of (23.6+/-13.8) months; the preoperative Lysholm score ranged from 19 to 28 scores, averaged (24.3+/-3.3) scores. In the control group, there were 30 patients, including 13 males and 17 females, ranging in age from 47 to 79 years, with an average of (62.5+/-9.3) years; the course of disease ranged from 8 to 45 months, with a mean of (24.6+/-16.6) months; the preoperative Lysholm score ranged from 20 to 29 scores, averaged (25.9+/-3.0) scores. The patients in the treatment group were treated with moxibustion, and the patients in control group were treated with infrared therapy. All the patients were followed up for 4 weeks. The Lysholm scores were compared between the two groups. RESULTS: According to Lysholm score for clinical efficacy, treatment group got (87.5+/-5.6) scores and the control group were (85.9+/-3.5) scores, the Lysholm score of the treatment group was higher than that of the control group (P<0.05). Among pain score, joint flexion and extension score, joint stability score, and up and down stairs score, the pain and joint stability scores of patients in the treatment group were higher than those of control group (P<0.05). CONCLUSION: Compared with infrared therapy, moxibustion treatment for knee osteoarthritis can get better joint function, which is effect to alleviate the patient's pain, improve joint stability, improve the efficacy, and is valued to be promoted.

[Introduction of clinical pathway and thoughts on its application in Chinese medicine practice].

This assay introduces the origin, basic concept of clinical pathway, the current status of the development of clinical pathway, the basic principle and method of developing clinical pathway, and the common and different aspects between clinical pathway and clinical practice guideline, as well as the possible application of clinical pathway into Chinese medicine.

[Evaluation of the clinical effect of knee osteoarthritis treated with moxibustion according to WHOQOL-BREF].

OBJECTIVE: To investigate and research WHOQOL-BREF evaluation of the clinical effect of application of moxibustion for treatment of knee osteoarthritis, to provide clinical according for the treatment. METHODS: From January 2007 to June 2008, 90 cases of knee osteoarthritis were randomly divided into treatment group and control group. In treatment group there were 45 cases included 16 males and 29 females with an average age of (62.5 +/- 7.4) years; the average course was (26.5 +/- 14.6) months; Lysholm score of knee function before treatment was (65.5 +/- 3.5) hours on average. In control group, there were 45 cases included 11 males and 34 females with an average age of (62.5 +/- 9.3) years;the average course was (24.6 +/- 16.6) months; Lysholm score of knee function before treatment was (66.3 +/- 2.3) hours on average. Applied Quality of Life Scale WHOQOL-BREF in line with the inclusion criteria of the study evaluation. While applied Lysholm scoring of knee joint for supporting the evaluation criteria. All data were statistical analyzed by package SPSS 11.5. RESULTS: Moxibustion was applied to treat the knee osteoarthritis and the quality of life was evaluated according to the WHOQOL-BREF scale score. The scores of the physical state, psychological state, as well as their own general health status of subjective feeling, and so on in treatment was significantly higher than that in control group (P < 0.05). According to Lysholm scoring, the score in treatment group was significantly higher than that of control group, too (t = 0.65, P < 0.05). CONCLUSION: Application of moxibustion for treatment of knee osteoarthritis is a simple, economical and practical, and can avoid the further development of the disease, but also to improve the joint function and improve quality of life.

[Survey on factors influencing the use of suitable techniques on Chinese medicine in the countryside in 10 provinces].

OBJECTIVE: To study the effective factors and difficulties in the application of Suitable Technique of Chinese Medicine(STCM) in the countryside. METHODS: A survey on current situation was carried out on incumbency doctors in 12 cities with a self-designed questionnaire. RESULTS: In 1387 available questionnaire, 51.8% of the doctors agreed with the active application of some STCM in the countryside while 42.8% thought that they could be promoted. Factors as age,titles of professional, jobs and holding a diploma had close relation with their attitude to the application of techniques in their cities (P < 0.01). CONCLUSION: Suitable technique of CM could be adopted by the rural doctors working at the grassroot healthcare unit, suggesting that these techniques should be popularized step by step.