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1.
Front Pharmacol ; 15: 1321405, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38560355

RESUMEN

Backgroud: The co-administration of Chinese patent medicine with calcium channel blockers (CCBs) is a prevalent practice in China for treating essential hypertension (EH). However, robust evidence supporting the efficacy and safety of tailored combinations of different Chinese patent medicines with CCBs, according to individual patient conditions, is still limited. This study sought to elucidate the efficacy and safety of these combinations using a systematic review and network meta-analysis. Materials and methods: Relevant studies were sourced from established databases, incorporating randomized controlled trials published up to 1 February 2023. The ROB2 tool from the Cochrane Collaborative Network was employed to independently assess and cross-verify the quality of the included literature. A network meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 and PRISMA-Network Meta-Analyses (PRISMA-NMA) guidelines. A Bayesian network meta-analysis was utilized to gauge the efficacy and safety of distinct integrations of Chinese patent medicine and CCBs. Primary outcomes were interpreted using a paired fixed-effect meta-analysis. Publication bias was appraised through Egger's test and represented with funnel plots. All statistical analyses were executed within the R statistical framework. Results: Following rigorous selection, data extraction, and bias evaluation, 36 articles were incorporated. Tianma Gouteng Granule, when combined with CCBs, displayed superior efficacy in reducing systolic blood pressure (SBP). In terms of diastolic blood pressure (DBP) reduction, Songling Xuemaikang Capsule combined with CCBs emerged as the most effective. Regarding enhancement of antihypertensive effective rates, Qinggan Jiangya Capsule paired with CCBs demonstrated optimal results. For diminishing Traditional Chinese Medicine syndrome scores, the Qiangli Dingxuan Tablet and CCBs combination proved most beneficial. When aiming to reduce total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels, Tianma Gouteng Granule and CCBs showcased superior results. In contrast, the combination of Songling Xuemaikang Capsule and CCBs was more effective in reducing LDL-C, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Conclusion: This study underscores variability in outcomes from combining Chinese patent medicine and CCBs for hypertension, emphasizing the importance of personalized medicinal combinations, especially Tianma Gouteng Granule and Songling Xuemaikang Capsule. The results offer robust evidence to inform clinical guidelines for essential hypertention and significantly aid clinician in seleting appropriate Chinese patent medicines for treatment.

2.
Front Chem ; 12: 1356458, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38496269

RESUMEN

Background: With the increasing global prevalence of hypertension, a condition that can severely affect multiple organs, there is a growing need for effective treatment options. Uncaria rhynchophylla-Alisma plantago-aquatica L. (UR-AP) is a traditional drug pair used for treating hypertension based on the liver-kidney synergy concept. However, the detailed molecular mechanisms underlying its efficacy remain unclear. Methods: This study utilized an integrative approach combining network pharmacology, cluster analysis, and molecular docking to uncover the bioactive components and targets of UR-AP in the treatment of hypertension. Initially, we extracted data from public databases to identify these components and targets. A Protein-Protein Interaction (PPI) network was constructed, followed by enrichment analysis to pinpoint the bioactive components, core targets, and pivotal pathways. Cluster analysis helped in identifying key sub-networks and hypothesizing primary targets. Furthermore, molecular docking was conducted to validate the interaction between the core targets and major bioactive components, thus confirming their potential efficacy in hypertension treatment. Results: Network pharmacological analysis identified 58 bioactive compounds in UR-AP, notably quercetin, kaempferol, beta-sitosterol (from Uncaria rhynchophylla), and Alisol B, alisol B 23-acetate (from Alisma plantago-aquatica L.), as pivotal bioactives. We pinpointed 143 targets common to both UR-AP and hypertension, highlighting MAPK1, IL6, AKT1, VEGFA, EGFR, and TP53 as central targets involved in key pathways like diastolic and endothelial function, anti-atherosclerosis, AGE-RAGE signaling, and calcium signaling. Cluster analysis emphasized IL6, TNF, AKT1, and VEGFA's roles in atherosclerosis and inflammation. Molecular docking confirmed strong interactions between these targets and UR-AP's main bioactives, underscoring their therapeutic potential. Conclusion: This research delineates UR-AP's pharmacological profile in hypertension treatment, linking traditional medicine with modern pharmacology. It highlights key bioactive components and their interactions with principal targets, suggesting UR-AP's potential as a novel therapeutic option for hypertension. The evidence from molecular docking studies supports these interactions, indicating the relevance of these components in affecting hypertension pathways. However, the study acknowledges its limitations, including the reliance on in silico analyses and the need for in vivo validation. These findings pave the way for future clinical research, aiming to integrate traditional medicine insights with contemporary scientific approaches for developing innovative hypertension therapies.

3.
J Integr Plant Biol ; 65(10): 2395-2406, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37485903

RESUMEN

Pollen hydration on dry stigmas is strictly regulated by pollen-stigma interactions in Brassicaceae. Although several related molecular events have been described, the molecular mechanism underlying pollen hydration remains elusive. Multiple B-class pollen coat proteins (PCP-Bs) are involved in pollen hydration. Here, by analyzing the interactions of two PCP-Bs with three Arabidopsis thaliana stigmas strongly expressing S-domain receptor kinase (SD-RLK), we determined that SD-RLK28 directly interacts with PCP-Bß. We investigated pollen hydration, pollen germination, pollen tube growth, and stigma receptivity in the sd-rlk28 and pcp-bß mutants. PCP-Bß acts in the pollen to regulate pollen hydration on stigmas. Loss of SD-RLK28 had no effect on pollen viability, and sd-rlk28 plants had normal life cycles without obvious defects. However, pollen hydration on sd-rlk28 stigmas was impaired and pollen tube growth in sd-rlk28 pistils was delayed. The defect in pollen hydration on sd-rlk28 stigmas was independent of changes in reactive oxygen species levels in stigmas. These results indicate that SD-RLK28 functions in the stigma as a PCP-Bß receptor to positively regulate pollen hydration on dry stigmas.


Asunto(s)
Arabidopsis , Arabidopsis/metabolismo , Polen/metabolismo , Comunicación Celular
4.
Genes Genomics ; 45(7): 921-934, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37004590

RESUMEN

BACKGROUND: The plant-specific valine-glutamine (VQ) motif containing proteins tightly regulate plant growth, development, and stress responses. However, the genome-wide identification and functional analysis of Brassica oleracea (B. oleracea) VQ genes have not been reported. OBJECTIVE: To identify the VQ gene family in B. oleracea and analyze the function of Bo25-1 in pollen germination. METHODS: The Hidden Markov Model (HMM) of VQ family was used to query the BoVQ genes in the B. oleracea genome. The BoVQ genes preferentially expressed in anthers were screened by qRT-PCR. Subcellular localization of VQ25-1 was observed in Nicotiana benthamiana (N. benthamiana) leaves. To analysis the role of BoVQ25-1 in pollen germination, the expression of BoVQ25-1 was suppressed using antisense-oligonucleotides (AS-ODN). RESULTS: A total of 64 BoVQ genes were identified in the B. oleracea genome. BoVQ25-1 was found to be preferentially expressed in the B. oleracea anthers. BoVQ25-1 was cloned from the anthers of the B. oleracea cultivar 'Fast Cycle'. BoVQ25-1 is localized to the nucleus. The pollen germination rate significantly decreased after AS-ODN treatment. CONCLUSION: Sixty-four BoVQ genes were identified in the B. oleracea genome, of which BoVQ25-1 plays an important role in pollen germination.


Asunto(s)
Brassica , Glutamina , Glutamina/metabolismo , Valina/metabolismo , Germinación/genética , Brassica/metabolismo , Polen/genética
5.
Zhongguo Zhen Jiu ; 41(1): 85-8, 2021 Jan 12.
Artículo en Chino | MEDLINE | ID: mdl-33559449

RESUMEN

The ISO 22236 Traditional Chinese medicine-Thread-embedding acupuncture needle for single use, as the first international standard (IS) in acupoint thread-embedding field, has been officially published by International Organization for Standardization (ISO) in 2020. The background of its development, difficulties and countermeasures in the process of development were reviewed, and the experience of standard development was summarized, aiming to provide methods and references for future IS development of acupuncture and moxibustion instruments. It is suggested that strengthening the discourse power in the process of IS development, increasing the compound talents cultivation for IS, valuing the importance of enterprises in the development of IS, and creating an advantageous environment for the development of IS are the keys to improve the level of standardization of acupuncture and moxibustion instruments and play a more important role in the IS development.


Asunto(s)
Terapia por Acupuntura , Acupuntura , Moxibustión , Puntos de Acupuntura , Medicina Tradicional China , Estándares de Referencia
6.
J Tradit Chin Med ; 40(6): 891-896, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33258339

RESUMEN

OBJECTIVE: To summarize the evidence from Traditional Chinese Medicine (TCM) practice in the treatment of coronavirus disease 2019 (COVID-19) and provide timely clinical practice guidance. METHODS: The guidelines were developed in accordance with the World Health Organization rapid guideline process. The evidence on TCM for COVID-19 from published guidelines, direct and indirect published clinical evidence, first hand clinical data, and expert experience and consensus were collected. The grading of recommendations assessment, development and evaluation (GRADE) method was used to grade the evidence and make the recommendations. RESULTS: Based on the available evidence, the guidelines recommended 17 Chinese medicines for COVID-19: 2 Chinese herbal granules, 7 Chinese patent medicines, and 8 Chinese herbal injections. CONCLUSION: As the literature search was conducted on March, any subsequent versions of these guidelines require an up-to-date literature review. We hope that the evidence summary in these will be helpful in global efforts to address COVID-19.


Asunto(s)
Medicamentos Herbarios Chinos/uso terapéutico , Medicina Tradicional China/métodos , Humanos , SARS-CoV-2/patogenicidad , Tratamiento Farmacológico de COVID-19
7.
Chin J Integr Med ; 24(7): 545-550, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27933511

RESUMEN

OBJECTIVE: To evaluate the quality and consistency of recommendations in the clinical practice guidelines (CPGs) for hypertension in Chinese medicine (CM). METHODS: CM CPGs were identified from 5 electronic databases and hand searches through related handbooks published from January 1990 to December 2013. Three reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and compared the CPGs' recommendations on CM syndrome pattern classification and treatment. RESULTS: Five CM CPGs for hypertension were included. The quality score of the evidence-based (EB) guideline was higher than those of the consensus-based with no explicit consideration of evidence-based (CB-EB) and the consensus-based (CB) guidelines. Three out of five patterns in the CPGs were recommended by the EB guideline. Tianma Gouteng Formula () in the EB guideline was recommended mostly for hypertension patients with pattern of ascendant hyperactivity of Gan (Liver)-yang and pattern of yin deficiency with yang hyperactivity in the CPGs. Acupuncture and massage were recommended for Grade I and Grade II hypertension with severe symptoms weakening the quality of life in the EB guideline. For Grade I and Grade II hypertension, CM could be used alone, while for Grade III hypertension, they should be used in combination with Western medicines. CONCLUSION: The quality of EB guideline was higher than those of CB and CB-EB CPGs in CM for hypertension and CM should be prescribed alone or combined with Western medicines based on the grade of hypertension.


Asunto(s)
Hipertensión/terapia , Medicina Tradicional China/normas , Guías de Práctica Clínica como Asunto/normas , Calidad de la Atención de Salud/normas , Humanos , Medicina Tradicional China/métodos , Garantía de la Calidad de Atención de Salud , Calidad de Vida
8.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3233-3237, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192427

RESUMEN

To evaluate the applicability and clinical applications of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine, so as to provide the basis for the revision of the guidelines. This study was completed by the research and promotion base for traditional Chinese medicine(TCM) standard. The methods of applicability evaluation and application evaluation were used in the study. The questionnaires were filled out to evaluate applicability of the guideline, including doctor's familiarity with the guideline,the quality of the guideline, applicable conditions and clinical applications. The prospective case study analysis method was used to evaluate application of the guideline, including evaluation of clinical application compliance and application results(such as clinical effects, safety and economy). There were two parts in the guideline, which were TCM guideline and Western medicine guideline. The results of applicability evaluation showed that there were no obvious differences between TCM guideline and Western medicine guideline in doctor's familiarity with guideline(85.43%, 84.57%) and the use of the guideline(52.10%, 54.47%); the guidelines with good quality, and higher scores in the scope of application and the use of the term rationality(91.94%, 93.35%); the rationality scores of relevant contents in syndrome differentiation and treatment were more than 75%; the applicable conditions were better, and the safety score was the the highest. The comprehensive applicability evaluation showed that the proportion of the application of TCM guideline and Western medicine guideline were 77.73%, 75.46%, respectively. The results of application evaluation showed that there was high degree coincidence between the guideline with its clinical application; except for "other treatment" and "recuperation and prevention" in TCM, other items got high scores which were more than 90%; in the evaluation of application effects, safety of the guideline was best, economy of the guideline was better, and clincal effect was good. The comprehensive application evaluation showed that 75%~80% doctors were satisfied with the guideline. The Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine has been widely used in clinical practice, which is of high quality, high degree of clinical application,good safety and economy. But there were some disadvantages of the guideline such as lack of evidence-based medicine and innovation, which is need to be improved constantly in the guideline revision.


Asunto(s)
Medicina Interna , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Humanos , Estudios Prospectivos , Investigación
9.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3238-3242, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192428

RESUMEN

Clinical application evaluation research of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine intends to evaluate the quality level and clinical application of the guideline. A questionnaire and prospective case survey methods were used to evaluate the applicability evaluation based on the clinician questionnaire and the application evaluation based on clinical case observation. The applicability evaluation, familiarity and utilization rate of doctors' guidelines were 85.06%, 62.76%; Sort by technical grade, intermediate grade doctors have a higher familiarity rate and utilization rate, while the junior grade doctor's is lower; Guide quality level of applicability evaluation, other items' rational percentage are better than 96% except the items of health preserving and prevention and other treatment is relatively low; Items' applicable percentage of applicability evaluation are more than 91% except the item of guide simplicity. Comprehensive applicability evaluation, The percentage of the guideline applicable to clinical practice accounted for 94.94%. The consistency rate of syndrome differentiation and clinical application is more than 96% in addition to prescription medication, other treatments and health preserving and prevention of the guidelines apply consistency of application evaluation. The percentage of good treatment effect accounted for 92.96% of application effect evaluation. The safety percentage is 99.89% and economy is 97.45%. The research shows that of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine quality level is good and is basically applicable to pediatric clinical practice which can be used as a standardized recommendation of pediatric common diseases' treatment specification. A small part of the guidelines are not applicable and need to be further consummated. Health preserving and prevention and other treatment of the guideline need to be revised.


Asunto(s)
Medicina Tradicional China , Pediatría/normas , Guías de Práctica Clínica como Asunto , Niño , Humanos , Médicos , Estudios Prospectivos , Encuestas y Cuestionarios
10.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3243-3246, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192429

RESUMEN

This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased.


Asunto(s)
Medicina Tradicional China , Otolaringología , Guías de Práctica Clínica como Asunto , Humanos , Estudios Prospectivos , Encuestas y Cuestionarios
11.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3252-3256, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192431

RESUMEN

To provide reference for revising the Guidelines for Diagnosis and Treatment of Common Diseases of Coloproctology in Traditional Chinese Medicine (TCM) through clinical research. 9 TCM hospitals worldwide have conducted a survey and questionnaires for 7 CPGs have been received. 263 cases clinical doctors accepted the applicability survey of guidelines. 89.35% is more familiar to the guidelines and 36.12% have been used the guidelines. In syndrome differentiation and treatment related contents, diagnostic point, treatment and syndrome differentiation are higher, accounted for 96.96%, 88.59%, 96.20%, respectively. Rationality of prevention is lower, accounted for 65.02%.88.21% clinical doctors believe that the Guidelines for Diagnosis and Treatment of Common Diseases of Coloproctology in Traditional Chinese Medicine is applicable. The application of the guidelines is evaluated by prospective observation of 1 309 cases. The higher consistency between guidelines and clinical practice is Western medicine disease diagnosis and traditional Chinese medicine disease diagnosis, accounted for 98.70%, 90.76%, respectively. The lower is rationality of prevention, accounted for 49.27%. The safety and economy of the guidelines are better, accounted for 97.02%, 95.11%, respectively. The comprehensive evaluation results showed that the overall treatment effect and technical level, satisfaction degree, applicability in clinical practice which were 7-9 points is 81.52%, 80.60%, 79.30%.The complex evaluation of diagnosis and treatment of common diseases of coloproctology in TCM guidelines is good, and suitable for clinical application with increase the content of rationality of prevention.


Asunto(s)
Cirugía Colorrectal , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Humanos , Estudios Prospectivos
12.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3247-3251, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192430

RESUMEN

This study aims to evaluate the adaptability and applicability of Guidelines for the Diagnosis and Treatment of Cancer in Traditional Chinese Medicine. The assessment methods included adaptability assessment and applicability assessment. The adaptability assessment was based on the questionnaire survey to evaluate the familiarity, utilization, quality, and clinical application of the Guidelines; applicability assessment was based on the prospective observation of 853 clinical cases to investigate the applicability and effect of the Guidelines, including effectiveness, economy and safety. Statistical analysis for basic description, construction of different comparison groups for cross or hierarchical statistical test, multi-factor analysis, and confounding factors were used in the study. Adaptability assessment results showed that 63.03% of TCM doctors considered guidelines as good or very good applicability and 4.24% of TCM doctors considered guidelines with very poor applicability in clinical practice. For the applicability evaluation, TCM doctors considered that the "overall efficacy and technology level", "satisfactory degree" and "adaptability in clinical practice" of the guideline were 85.46%, 80.43% and 69.40% respectively. The results showed that guideline was well known among TCM doctors, especially junior TCM doctors. Adaptability and applicability of Guidelines were totally good but the quality and adaptability of the intervention schemes were still week, so the quality of Guidelines should be improved by revision.


Asunto(s)
Oncología Médica , Medicina Tradicional China , Neoplasias/terapia , Guías de Práctica Clínica como Asunto , Humanos , Estudios Prospectivos
13.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3262-3266, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192433

RESUMEN

To evaluate the clinical applicability and application of Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine, 11 diseases from Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine were evaluated by methods of questionnaire and prospective case study at 16 construction units for traditional Chinese medicine standards research and extension. Results showed that 361 clinical doctors accepted the applicability survey of guidelines, and 87.26% of them were more familiar to the guideline and 25.21% of them used the guideline. In syndrome differentiation and treatment related contents, rationality of prescription medication and syndrome classification was higher, accounted for 91.69% and 86.98% respectively, but the rationality of recuperation prevention was lower, accounted for 44.6%. 75.62% clinical doctors believed that the Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine was applicable. The application of the guidelines is evaluated by prospective observation of 2 935 cases. The higher compliance between the guideline and clinical practice was present in TCM (traditional Chinese medicine) disease diagnosis and WM (western medicine) disease diagnosis, accounted for 98.30% and 94.11% respectively. The lower compliance was present in recuperation prevention, accounted for 59.39%. The safety and economy of the guideline was higher, accounting for 95.64%, 94.75%, respectively. The comprehensive evaluation results showed that the rate of the overall treatment effect with technical level, satisfaction degree or applicability in clinical practice which were 7-9 points is 77.38%, 74.00%, 76.90% respectively. This guideline has a high clinical compliance and can be used as a standard for common diseases of gynecology, but there are also some conditions with poor applicability, which does not conform to the actual situation, and needs to be further revised.


Asunto(s)
Ginecología , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Femenino , Humanos , Estudios Prospectivos , Estándares de Referencia , Encuestas y Cuestionarios
14.
Zhongguo Zhong Yao Za Zhi ; 42(17): 3257-3261, 2017 Sep.
Artículo en Chino | MEDLINE | ID: mdl-29192432

RESUMEN

To assess the quality and application effect of Guidelines for Diagnosis and Treatment of Common Diseases of Dermatology in Traditional Chinese Medicine(Guidelines) through the applicability and applicability evaluation respectively. The questionnaire survey was adopted to evaluate the applicability of the Guidelines, including the utilization, quality, and clinical application conditions. The results showed that the familiarity rate and utilization rate of the Guidelines were 85.37%, 48.78%, respectively. The data showed that the familiarity and the utilization rates were different in the working staff with different professional titles. The evaluation level was the lowest given by the staff with junior professional title (70.97%, 29.03%) in comparison. The assessment showed the overall quality of the Guideline was good and slightly low level for the rationality scores of the other therapeutic methods as well as for the recuperation and prevention (80.49%, 85.37%), which was in line with the clinical compliance of the Guideline. The perspective observation of clinical cases was used for the applicability evaluation, including clinical compliance of the Guideline, effect evaluation, and comprehensive assessment, et al. The results showed that the safety score was the highest, followed by the economic issue and efficacy. For the comprehensive evaluation of the applicability, complete applicability accounted for 29.27%, and the general applicability accounted for 87.80%. It was showed in the three index scores of the applicability evaluation that the accumulative score 7-9 scores were 75.65%, 73.89%, 71.12%. Through the applicability and applicability evaluation, the Guideline was satisfactory in the overall quality, high in the safety of clinical application and good in efficacy and economic issues. There are some limits on the development method and technical issues in the Guideline, which is required to be supplemented in the revision. Additionally, the strategy study on the promotion of the Guideline should be enhanced so as to expedite the recognition and utilization of the Guideline.


Asunto(s)
Dermatología , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Humanos , Encuestas y Cuestionarios
15.
BMC Complement Altern Med ; 17(1): 451, 2017 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-28877689

RESUMEN

BACKGROUND: Clinical practice guidelines (CPGs) for Chinese medicine (CM) are being developed to assist doctors with appropriate decisions concerning CM care. To date, there has been little investigation on the perspectives of those to whom the guidelines are directed. METHODS: A self-administered questionnaire was sent to 4503 doctors in 28 provinces of China in the latter half of 2012. Questions were organized around the topics of knowledge, application, practice changes, beliefs and outcomes of implementation. Basic classificatory data on specialties and years of qualification were also collected. RESULTS: Replies were received from 4495 CM doctors (99.82%). Of these, 85.56% of CM doctors reported being familiar with CPG recommendations, but the overall adherence rate was only 50.39%. The length of time practicing CM may influence the rate of adherence, since 709 doctors (51.90%) with less than 5 years of experience reported never having followed CPGs. Doctors in nine specialties showed a modest degree of homogeneity in their attitudes towards CM diagnosis and treatment, which were generally positive. Most doctors regarded CPG-recommended therapies as safe (92%), economic (84%), and effective (76%). Approximately four-fifths of those questioned selected 'acceptable' (60.84%) and 'acceptable after revision' (19.23%) regarding their comprehensive assessment of the CPGs. CONCLUSIONS: An encouraging result from this survey is that the majority of CM doctors support the concept of CPGs for the practice of CM. However, the results of this survey also suggest that improving the adherence of CM doctors to the guidelines remains a major challenge to improving the practice standards for CM.


Asunto(s)
Medicina Tradicional China , Médicos/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Actitud del Personal de Salud , China/epidemiología , Estudios Transversales , Humanos , Encuestas y Cuestionarios
16.
Chin J Integr Med ; 23(5): 376-380, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-26779713

RESUMEN

OBJECTIVE: To review the current situation and progress of traditional Chinese medicine (TCM) international standards, standard projects and proposals in International Organization for Standardization (ISO)/ technical committee (TC) 249. METHODS: ISO/TC 249 standards and standard projects on the ISO website were searched and new standard proposals information were collected from ISO/TC 249 National Mirror Committee in China. Then all the available data were summarized in 5 closely related items, including proposed time, proposed country, assigned working group (WG), current stage and classifification. RESULTS: In ISO/TC 249, there were 2 international standards, 18 standard projects and 24 new standard proposals proposed in 2014. These 44 standard subjects increased year by year since 2011. Twenty-nine of them were proposed by China, 15 were assigned to WG 4, 36 were in preliminary and preparatory stage and 8 were categorized into 4 fifields, 7 groups and sub-groups based on International Classifification Standards. CONCLUSION: A rapid and steady development of international standardization in TCM can be observed in ISO/TC 249.


Asunto(s)
Internacionalidad , Medicina Tradicional China/normas , Comités Consultivos , Humanos , Estándares de Referencia , Factores de Tiempo
17.
Artículo en Inglés | MEDLINE | ID: mdl-25815035

RESUMEN

We presented a study protocol of developing Chinese medicine clinical practice guidelines for three common diseases in Hong Kong, including insomnia, chronic gastritis, and cerebral infarction. This research project will be conducted in three phases. First phase is the preparation stage which consists of the establishment of steering committee and panel. Second phase involves 6 steps, which are searching and identifying evidence, text mining process, Delphi survey, synthesizing of data, consensus conference, and drafting guidelines. In this phase, text mining technique, evidence-based method, and formal consensus method are combined to get consolidated supporting data as the source of CM CPGs. The final phase comprised external reviews, dissemination, and updating. The outputs from this project will provide three CM CPGs for insomnia, chronic gastritis, and cerebral infarction for Hong Kong local use.

18.
J Integr Med ; 13(2): 122-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25797643

RESUMEN

BACKGROUND: Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension (RH), its control is still a challenge for conventional medicine. The Chinese herbal formula, Qutan Huayu Fang, has been used effectively to assist antihypertensive agents in blood pressure control, but its effect for RH patients is still unclear. This pilot study aims to explore the effects of taking the formula in addition to antihypertensive medication in the management of RH. METHODS/DESIGN: A prospective cohort study will be conducted in two first-class hospitals of traditional Chinese medicine (TCM). Eligible RH patients will be classified as the experimental group (n = 100) and the control group (n = 100) based on the interventions they receive. Participants taking antihypertensive agents and the Chinese herbal formula will be in the experimental group and those taking antihypertensive agents alone will be in the control group. The whole study will last 24 weeks, including an 8-week observation and follow-up at 24 weeks. The primary outcomes, assessed against patient baseline conditions, will be the reduction of systolic blood pressure and diastolic blood pressure as well as changes in TCM symptoms and signs. These outcomes will be assessed at weeks 2, 4, 6, and 8. The reductions of blood pressure will also be assessed at week 24. Cardiac events and mortality rate will be secondary outcomes and will be assessed at weeks 8 and 24. Any adverse reactions will be recorded during the study. The causal inference method will be used to assess the effectiveness of the inclusion of TCM herbal medicine in the management of patients with RH. DISCUSSION: This study will determine whether the Chinese herbal formula is helpful for RH patients treated with antihypertensive agents and the findings will provide a basis for further confirmatory studies.


Asunto(s)
Antihipertensivos/farmacología , Presión Sanguínea/efectos de los fármacos , Medicamentos Herbarios Chinos/farmacología , Hipertensión , Protocolos Clínicos , Estudios de Cohortes , Resistencia a Medicamentos , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Masculino , Proyectos Piloto , Plantas Medicinales , Estudios Prospectivos , Resultado del Tratamiento
19.
Chin J Integr Med ; 21(9): 707-15, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24938446

RESUMEN

OBJECTIVE: To systematically review the clinical practice guidelines (CPGs) for ischemic stroke in Chinese medicine (CM) with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. METHODS: CM CPGs for ischemic stroke were searched in 5 online databases and hand-searches in CPGrelated handbooks published from January 1990 to December 2012. The CPGs were categorized into evidence based (EB) guideline, consensus based with no explicit consideration of evidence based (CB-EB) guideline and consensus based (CB) guideline according to the development method. Three reviewers independently appraised the CPGs based on AGREE II instrument, and compared the CPGs' recommendations on CM pattern classification and treatment. RESULTS: Five CM CPGs for ischemic stroke were identified and included. Among them, one CPG was EB guideline, two were CB guidelines and two were CB-EB guidelines. The quality score of the EB guideline was higher than those of the CB-EB and CB guidelines. Five CM patterns in the CPGs were recommended in the EB CPG. The comprehensive protocol of integrative Chinese and Western medicine recommended in the EB CPG was mostly recommended for ischemic stroke in the CPGs. The recommendations varied based on the CM patterns. CONCLUSION: The quality of EB CPG was higher than those of CB and CB-EB CPGs in CM for ischemic stroke and integrative approaches were included in CPGs as major interventions.


Asunto(s)
Isquemia Encefálica/complicaciones , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia , Investigación Biomédica , Isquemia Encefálica/terapia , Directrices para la Planificación en Salud , Humanos
20.
J Altern Complement Med ; 19(1): 1-8, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22954464

RESUMEN

BACKGROUND: Increasing Clinical Practice Guidelines (CPGs) of Traditional Chinese Medicine (TCM) have been developed in China, and it is not clear about the real application in the clinical studies. This study aimed to analyze the adoption of CPGs for hypertension using TCM therapy by investigating the clinical research literature on representative CPGs for TCM in China. METHODS: All CPGs on TCM for hypertension were collected and investigated from all of the clinical research literature published in China from January 2005 to December 2010. Ten (10) CPGs on TCM for hypertension were searched and analyzed, collecting data about the issuing organization, date of publication, classification, characteristics, contents, and citation rates. RESULTS: By the end of December 2008, 10 CPGs on TCM for hypertension were found. Of these guidelines, one was a Chinese national standard, one was a local authority standard, two were professional administration standard, and six were academic association standards. Furthermore, four were compiled under the title of hypertension based on TCM syndrome differentiation and six were only compiled under the title of a TCM syndrome. Of all the research articles (n=695), TCM CPGs were cited in 417 articles (60%). TCM CPGs on hypertension were commonly used as standards for diagnosis and/or outcome measurements. Three hundred and seventy-nine (379) clinical research articles were unclear or inconsistent in their adoption of TCM CPG, accounting for 55% of all clinical articles. Seven (7) categories of inconsistent or unclear citations of TCM CPG were identified, and the total amount of occurrences of seven categories on inconsistent citation was 572. CONCLUSIONS: About 60% publications cited the CPGs for their clinical research, and most of them cited in an inconsistent and unclear way. According to the result, better training of TCM practitioners and improvement of CPG development and adoption are needed.


Asunto(s)
Investigación Biomédica/normas , Atención a la Salud/métodos , Hipertensión/terapia , Medicina Tradicional China , Guías de Práctica Clínica como Asunto , Proyectos de Investigación , China , Diagnóstico Diferencial , Humanos , Edición
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