An innovative method to accommodate chinese medicine pattern diagnosis within the framework of evidence-based medical research

Abstract

Pattern diagnosis is an integral aspect of Chinese medicine (CM). CM differentiates biomedical diseases into patterns, based upon the patient's symptoms and signs. Pattern identification (PI) is used to diagnose, direct the treatment principle and determine the treatment protocol. Most CM research has used fixed formula treatments for Western-defined diseases with outcomes measured using objective biomedical markers. This article presents an innovative method used in a randomised controlled pilot study using acupuncture for participants with hepatitis C virus. Each participant's CM patterns were identified and quantified at baseline which directed the treatment protocol for the treatment group. Data identified that while each participant expressed different patterns at baseline all participants displayed multiple patterns. Six patterns showed some expression by all 16 participants; Liver (Gan) yin vacuity expressing a group aggregate mean percentage of 47.2, binding depression of Liver qi 46.9, and Liver Kidney (Shen) yin vacuity 45.1. Further sub category gender grouping revealed that pattern ranking changed with gender; Liver yin vacuity (male 53.4%, female 51.93%), binding depression of Liver qi (male 50.0%, female 42.86%) and Liver Kidney yin vacuity (male 42.9%, female 47.96%). The quantification of CM patterns described in this article permitted statistical evaluation of presenting CM patterns. Although this methodology is in its infancy it may have potential use in the integration of PI with rigorous evidence based clinical research. Biomedical markers often do not relate to symptom/signs and therefore this innovative measure may offer an additional CM evaluation methodology and further CM PI understanding.

Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

“…This difference in approach, however, is not entirely irreconcilable. In order to accommodate TCM principle, that is, replicating the diagnosis using “Syndrome Differentiation” and giving the corresponding individualized treatment within the rigorous framework of EBM, a systematic process for assessing symptoms and signs, the identification, and the quantification of TCM syndrome for a sample group of study subjects with the same Western medical diagnosis can be applied before and after treatment [ 21 ]. To quantify a syndrome for diagnosis, the signs and symptoms of each subject could be tabulated and matched against the typical signs and symptoms which characterize a particular TCM syndrome.…”

“…To quantify a syndrome for diagnosis, the signs and symptoms of each subject could be tabulated and matched against the typical signs and symptoms which characterize a particular TCM syndrome. The percentage match between the two could then serve as the score for a certain syndrome and a corresponding treatment protocol would be administered, allowing an “individualized” treatment in a standardized and reproducible way [ 21 ]. One way of assessing the intervention effects could be done by comparing the change in scores.…”

Current Situation and Perspectives of Clinical Study in Integrative Medicine in China

“…With medical science transforming from traditional experience medicine into evidence-based medicine, fundamental changes have taken place in clinical medicine. Therefore, following the principle of respecting science and evidence, it is of the utmost importance to enhance the level of clinical research evidence in TCM and integrative medicine [72][73][74].…”