FOLLOWUS
Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?
Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?
- 中国结合医学杂志（英文版） 2014年20卷第5期 页码：336-340
- Affiliations：
1. University College of Health Sciences -Campus Kristiania,Oslo,Norway
2. National Research Centre in Complementary and Alternative Medicine, UiT The Arctic University of Norway, Tromso,Norway
- Author bio：
- Funds：
DOI：10.1007/s11655-014-1809-3
中图分类号：纸质出版日期：2014，
网络出版日期：2014-5-2，
Scan for full text
Birch, S., Alraek, T. Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?., Chin. J. Integr. Med. 20, 336–340 (2014). https://doi.org/10.1007/s11655-014-1809-3
Stephen Birch, Terje Alraek. Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?[J]. Chinese Journal of Integrative Medicine, 2014,20(5):336-340.
Birch, S., Alraek, T. Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?., Chin. J. Integr. Med. 20, 336–340 (2014). https://doi.org/10.1007/s11655-014-1809-3 DOI：
Stephen Birch, Terje Alraek. Traditional East Asian medicine: How to understand and approach diagnostic findings and patterns in a modern scientific framework?[J]. Chinese Journal of Integrative Medicine, 2014,20(5):336-340. DOI： 10.1007/s11655-014-1809-3.
摘要
Research into the diagnostic methods and patterns of traditional East Asian medical (TEAM) systems of practice such as acupuncture and herbal medicine face certain challenges due to the nature of thinking in TEAM and the subjective basis of judgments made in practice. The TEAM-based diagnosis can take into account various findings and signs such as the appearance of the tongue
palpable qualities of the radial pulses
palpable qualities and findings on the abdomen
the complexion of the patient and so on. Both diagnostic findings and the patterns of diagnosis cannot be assumed to have objective bases or to be causally related to the complaints of the patient. However
the diagnoses of TEAM based acupuncture and herbal medicine have tended to look at pictures of the whole patient and rather than focus on a particular symptom
they have looked across a myriad of signs and symptoms to decide or identify the ‘pattern’ of diagnosis according to the theory in question. Although open for selective and subjective biases each diagnosis pattern always comes with a prescribed treatment tailored to the pattern. Further
the same research requirements needed for the validation of the diagnoses are needed also for these clinical observations and judgments. Hence
it is necessary
albeit challenging for research on TEAM diagnoses to first address these issues before proceeding to more complex investigations such as the development of instruments for making diagnostic observations
instruments for forming diagnostic conclusions or studies investigating the physiological bases of the diagnostic patterns. Preliminary work has started and instruments have been made
but we suggest that any instrumentation must necessarily be first validated by matching of the calibrated or scaled observations or judgments to observations made and agreed upon by relevant experts. Reliability of all observations and judgments are needed before any other tool
technology or more advanced approach can proceed and also whenever the natural system of diagnosis-treatment is applied in clinical trials. In this paper the authors highlight the core problems and describe a step wise process for addressing them.
Abstract
Research into the diagnostic methods and patterns of traditional East Asian medical (TEAM) systems of practice such as acupuncture and herbal medicine face certain challenges due to the nature of thinking in TEAM and the subjective basis of judgments made in practice. The TEAM-based diagnosis can take into account various findings and signs such as the appearance of the tongue
palpable qualities of the radial pulses
palpable qualities and findings on the abdomen
the complexion of the patient and so on. Both diagnostic findings and the patterns of diagnosis cannot be assumed to have objective bases or to be causally related to the complaints of the patient. However
the diagnoses of TEAM based acupuncture and herbal medicine have tended to look at pictures of the whole patient and rather than focus on a particular symptom
they have looked across a myriad of signs and symptoms to decide or identify the ‘pattern’ of diagnosis according to the theory in question. Although open for selective and subjective biases each diagnosis pattern always comes with a prescribed treatment tailored to the pattern. Further
the same research requirements needed for the validation of the diagnoses are needed also for these clinical observations and judgments. Hence
it is necessary
albeit challenging for research on TEAM diagnoses to first address these issues before proceeding to more complex investigations such as the development of instruments for making diagnostic observations
instruments for forming diagnostic conclusions or studies investigating the physiological bases of the diagnostic patterns. Preliminary work has started and instruments have been made
but we suggest that any instrumentation must necessarily be first validated by matching of the calibrated or scaled observations or judgments to observations made and agreed upon by relevant experts. Reliability of all observations and judgments are needed before any other tool
technology or more advanced approach can proceed and also whenever the natural system of diagnosis-treatment is applied in clinical trials. In this paper the authors highlight the core problems and describe a step wise process for addressing them.
关键词
researchdiagnosisdiagnostic methodspattern identificationreliabilitytraditional East Asian medical systems
Keywords
researchdiagnosisdiagnostic methodspattern identificationreliabilitytraditional East Asian medical systems
references
O’Brien KA, Birch S. A review of the reliability of traditional East Asian medicine diagnoses. J Altern Complement Med 2009;15:353–366.
Buriani A, Garcia-Bermejo ML, Bosisio E, Xu QH, Li HG, Dong XB, et al. Omic techniques in systems biology approaches to traditional Chinese medicine research: Present and future. J Ethnopharmacol 2012;140:535–544.
Dai JY, Sun SJ, Cao HJ, Zheng NN, Wang WY, Gou XJ, et al. Applications of new technologies and new methods in ZHENG differentiation. Evid Based Complement Alternat Med 2012;2012:298014.
Jiang M, Lu C, Zhang C, Yang J, Tan Y, Lu AP, et al. Syndrome differentiation in modern research of traditional Chinese medicine. J Ethnopharmacol 2012;140:634–642.
Chae Y, Chang DS, Lee SH, Jung WM, Lee IS, Jackson S, et al. Inserting needles into the body: a meta-analysis of brain activity associated with acupuncture needle stimulation. J Pain 2013;14:215–222.
Han JS. Physiology of acupuncture: a review of thirty years of research. J Altern Complement Med 1997;3(suppl 1):101–108.
Huang W, Pach D, Napadow V, Park K, Long X, Neumann J, et al. Characterizing acupuncture stimuli using brain imaging with FMRI-a systematic review and meta-analysis of the literature. PLoS One 2012;7(4):e32960.
Kawakita K, Shinbara H, Imai K, Fukuda F, Yano T, Kuriyama K. How do acupuncture and moxibustion act? — Focusing on the progress in Japanese acupuncture research. J Pharmacol Sci 2006;100:443–459.
Pomeranz B, Berman B. Scientific basis of acupuncture. In: G Stux, B Berman, B Pomeranz. Basics of acupuncture. 15th ed. Berlin: Springer-Verlag; 2003:1–86.
Zhang JG, Wang XM, McAlonan GM. Neural acupuncture unit: a new concept for interpreting effects and mechanisms of acupuncture. Evid Based Complement Altern Med 2012;2012:429412.
MRC, Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. Online document at: http://www.mrc.ac.uk/pru/pdfmrc_cpr.pdf Posted in 2000
Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:979–983.
Paterson C, Dieppe P. Characteristic and incidental (placebo) effects in complex interventions such as acupuncture. BMJ 2005;330:1202–1205.
Price S, Long AF, Godfrey M, Thomas KJ. Getting inside acupuncture trials-exploring intervention theory and rationale. BMC Complement Altern Med 2011;11:22.
Price S, Mercer SW, MacPherson H. Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. Patient Educ Couns 2006;63(1–2):239–245.
Birch S, Felt R. Understanding acupuncture. Edinburgh: Churchill Livingstone; 1999.
Wiseman N, Feng Y. A Practical Dictionary of Chinese Medicine. Brookline: Paradigm Publications; 1997.
Birch S, Lewith G. Acupuncture research, the story so far. In MacPherson H, Hammerschlag R, Lewith G, Schnyer R, eds. Acupuncture research: Strategies for building an evidence base. London: Elsevier; 2007:15–35.
Unschuld PU. Medicine in China: a history of ideas. Berkeley: University of California Press; 1985.
Birch S, Bovey M. Qi [氣], Jingmai [經脈]: Scientific investigation of concepts based in traditional East Asian medicine: challenges to cross-paradigm research. In Birch S, Cabrer Mir MA, Rodriguez M, eds. Restoring order in health and Chinese medicine: Studies of the development and use of qi and the channels. 2014.
Birch S. Testing the claims of traditionally based acupuncture. Complement Ther Med 1997;5:147–151.
MacPherson H, Sherman K, Hammerschlag R, Birch S, Lao L, Zaslawski C. The clinical evaluation of East Asian systems of medicine. Clin Acup Orient Med 2002:3:16–19.
Luo CH, Chung YF, Yeh CC, Si XC, Chang CC, Hu CS, et al. String like pulse quantification study by pulse wave in 3D pulse mapping. J Altern Complement Med 2012;18:924–931.
Chiu CC. A novel approach based on computerized image analysis for traditional Chinese medical diagnosis of the tongue. Computer Methods Prog Biomed 2000;61:77–89.
Chen RQ, Wong CM, Lam TH. Construction of a traditional Chinese medicine syndrome-specific outcome measure: the Kidney deficiency syndrome questionnaire (KDSQ). BMC Complement Altern Med 2012;12:73.
Ryu HH, Lee HJ, Kim HG, Kim JG. Reliability and validity of a cold-heat pattern questionnaire for traditional Chinese medicine. J Altern Complement Med 2010;16:663–667.
Amaral LAN, Diaz-Guilera A, Moreira AA, Goldberger AL, Lipsitz LA. Emergence of complex dynamics in a simple model of signaling networks. Proc Natl Acad Sci USA 2004;101:15551–15555.
Ivanov PCH, Amaral LAN, Goldberger AL, Stanley HE. Stochastic feedback and the regulation of biological rhythms. Europhys Lett 1998;43:363–368.
Mackey MC, Glass L. Oscillations and chaos in physiological control systems. Science 1977;197:287–289.
Goldberger AL. Non-linear dynamics for clinicians: chaos theory. Fractals and complexity at the bedside. Lancet 1996;347:1312–1314.
Goldberger AL, Amaral LAN, Glass L, Hausdorff JM, Ivanov PCh, Mark RG, et al. Physiobank, physiotoolkit, and physionet: Components of a new research resource for complex physiologic signals. Circulation 2000;101(23):e215–e220.
Goldberger AL, Amaral LAN, Hausdorff JM, Ivanov PC, Peng CK, Stanley HE. Fractal dynamics in physiology: Alterations with disease and aging. Proc Nat Acad Sci 2002;99(suppl 1):2466–2472.
Goldberger AL, Rigney DR, West BJ. Chaos and fractals in human physiology. Sci Am 1990;262:42–49.
Peng CK, Hausdorff JM, Goldberger AL. Fractal mechanisms in neural control: human heartbeat and gait dynamics in health and disease. In: Walleczek J, ed. Self-organized biological dynamics and nonlinear control. Cambridge: Cambridge University Press; 1999.
Ahn AC, Tewari M, Poon CS, Phillips RS. The limits of reductionism in medicine: could systems biology offer an alternative? PLoS Med 2006;3(6):e208.
Ahn AC, Tewari M, Poon CS, Phillips RS. The clinical application of a systems approach. PLoS Med 2006;3(7):e209.
Chen R, Mias GI, Li-Pook-Than J, Jiang JH, Lam HYK, Chen R, et al. Personal omics profiling reveals dynamic molecular and medical phenotypes. Cell 2012;148:1293–1307.
Hamburg MA, Collins FS. The path to personalized medicine. New Engl J Med 2010;363:301–304.
Nicholson JK. Global systems biology, personalized medicine and molecular epidemiology. Mol Syst Biol 2006;2:52.
Zhang GG, Lee WL, Bausell B, Lao LX, Handwerger B, Berman B. Variability in the traditional Chinese medicine (TCM) diagnoses and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis. J Altern Complement Med 2005;11:415–421.
Zhang GG, Singh B, Lee WL, Handwerger B, Lao LX, Berman L. Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training. J Altern Complement Med 2008;14:381–386.
Aird M, Coyle ME, Cobbin DM, Zaslawski CJ. A study of the comparative accuracy of two methods of locating acupuncture points. Acup Med 2000;18:15–21.
Rivers WE, Zollman F. Reliability of surface acupuncture point location. Med Acup 2013;25:134–140.
0
浏览量
795
Downloads
14
CSCD
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 邮编：100091
- 联系电话：010-62886827, 62877592 传真：010-62874291
- 技术支持由北京北大方正电子有限公司提供 京ICP备05067934号-1
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
