The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients - PubMed (original) (raw)
. 2004 Jan-Feb;10(1):58-63.
Affiliations
- PMID: 14727501
The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients
Grant G Zhang et al. Altern Ther Health Med. 2004 Jan-Feb.
Abstract
Context: The consistency of diagnosis made among Traditional Chinese Medicine (TCM) practitioners and the relationship between TCM diagnosis and Chinese herbal prescription have not been adequately examined.
Objective: To investigate the degree of consistency with which TCM diagnoses and herbal prescriptions can be made by practitioners examining rheumatoid arthritis (RA) patients. To survey TCM diagnostic patterns and to examine the correlation between herbal prescriptions and these diagnoses for a sample of RA patients.
Design: A prospective survey.
Setting: General Clinical Research Center, University of Maryland Hospital System, Baltimore, MD.
Patients: Rheumatoid arthritis patients. PRACTITIONERS: Licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs.
Methods: Three TCM practitioners examined the same 39 RA patients separately, following the traditional "Four Diagnostic Methods." Patients filled out a questionnaire to serve as the data for the "Inquiry" component. They then underwent a physical examination, including the tongue and pulse, conducted by each of the practitioners. Based upon the examination results, each practitioner provided both a TCM diagnosis and a herbal prescription. These diagnoses/prescriptions were then examined with respect to the rate of agreement among the 3 practitioners.
Results: The average agreement with respect to the TCM diagnoses among the 3 pairs of TCM practitioners was 28.2% (25.6 to 33.3% with kappas ranging from 0.23 to 0.30). The degree to which the herbal prescriptions agreed with textbook recommended practice of each TCM diagnosis was 93.2% (range = 87.2 to 100%).
Conclusion: The total agreement on TCM diagnosis on RA patients among 3 TCM practitioners was low. When less stringent, but theoretically justifiable, criteria were employed, greater consensus was obtained among the 3 practitioners. The correspondence between the TCM diagnosis and the herbal formula prescribed for that diagnosis was high, although there was little agreement among the 3 practitioners with respect to the herbal formulas prescribed for individual patients.
Similar articles
- Variability in the traditional Chinese medicine (TCM) diagnoses and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis.
Zhang GG, Lee W, Bausell B, Lao L, Handwerger B, Berman B. Zhang GG, et al. J Altern Complement Med. 2005 Jun;11(3):415-21. doi: 10.1089/acm.2005.11.415. J Altern Complement Med. 2005. PMID: 15992224 - Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training.
Zhang GG, Singh B, Lee W, Handwerger B, Lao L, Berman B. Zhang GG, et al. J Altern Complement Med. 2008 May;14(4):381-6. doi: 10.1089/acm.2007.0712. J Altern Complement Med. 2008. PMID: 18576921 - Effects of questionnaire-based diagnosis and training on inter-rater reliability among practitioners of traditional Chinese medicine.
Mist S, Ritenbaugh C, Aickin M. Mist S, et al. J Altern Complement Med. 2009 Jul;15(7):703-9. doi: 10.1089/acm.2008.0488. J Altern Complement Med. 2009. PMID: 19538100 Free PMC article. - The treatment of rheumatoid arthritis using Chinese medicinal plants: From pharmacology to potential molecular mechanisms.
Lü S, Wang Q, Li G, Sun S, Guo Y, Kuang H. Lü S, et al. J Ethnopharmacol. 2015 Dec 24;176:177-206. doi: 10.1016/j.jep.2015.10.010. Epub 2015 Oct 22. J Ethnopharmacol. 2015. PMID: 26471289 Review. - Clinical Strategy for Optimal Traditional Chinese Medicine (TCM) Herbal Dose Selection in Disease Therapeutics: Expert Consensus on Classic TCM Herbal Formula Dose Conversion.
Zha LH, He LS, Lian FM, Zhen Z, Ji HY, Xu LP, Tong XL. Zha LH, et al. Am J Chin Med. 2015;43(8):1515-24. doi: 10.1142/S0192415X1550086X. Epub 2015 Nov 30. Am J Chin Med. 2015. PMID: 26621440 Review.
Cited by
- Assessing the efficacy and safety of Juan Bi Tang for dialysis-related myofascial pain in the fistula arm: Study protocol for a randomized cross-over trial.
Hsu YT, Ng HY, Chen YH, Huang YC, Lee YY, Tsai MY. Hsu YT, et al. Front Public Health. 2022 Aug 19;10:925232. doi: 10.3389/fpubh.2022.925232. eCollection 2022. Front Public Health. 2022. PMID: 36062127 Free PMC article. - Global Research Trends of Herbal Medicine for Pain in Three Decades (1990-2019): A Bibliometric Analysis.
Wang C, Meng Q. Wang C, et al. J Pain Res. 2021 Jun 4;14:1611-1626. doi: 10.2147/JPR.S311311. eCollection 2021. J Pain Res. 2021. PMID: 34113168 Free PMC article. - Intra-Rater and Inter-Rater Reliability of Tongue Coating Diagnosis in Traditional Chinese Medicine Using Smartphones: Quasi-Delphi Study.
Wang ZC, Zhang SP, Yuen PC, Chan KW, Chan YY, Cheung CH, Chow CH, Chua KK, Hu J, Hu Z, Lao B, Leung CC, Li H, Zhong L, Liu X, Liu Y, Liu Z, Lun X, Mo W, Siu SY, Xiong Z, Yeung WF, Zhang RY, Zhang X. Wang ZC, et al. JMIR Mhealth Uhealth. 2020 Jul 9;8(7):e16018. doi: 10.2196/16018. JMIR Mhealth Uhealth. 2020. PMID: 32459647 Free PMC article. - Experimental Studies of Inter-Rater Agreement in Traditional Chinese Medicine: A Systematic Review.
Jacobson E, Conboy L, Tsering D, Shields M, McKnight P, Wayne PM, Schnyer R. Jacobson E, et al. J Altern Complement Med. 2019 Nov;25(11):1085-1096. doi: 10.1089/acm.2019.0197. J Altern Complement Med. 2019. PMID: 31730402 Free PMC article. - Application of Computer-Aided Tongue Inspection for Preliminary Screening of Esophageal Cancer.
Duan JL, Deng B, Song GH, Chen ZF, Gong YW, He YH, Jia LQ. Duan JL, et al. Chin J Integr Med. 2018 Oct;24(10):746-751. doi: 10.1007/s11655-018-2840-6. Epub 2018 Apr 17. Chin J Integr Med. 2018. PMID: 29671118
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical