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Article: The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients

TitleThe variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients
Authors
Issue Date2004
PublisherInnoVision Communications. The Journal's web site is located at www.alternative-therapies.com
Citation
Alternative Therapies In Health And Medicine, 2004, v. 10 n. 1, p. 58-63 How to Cite?
AbstractContext • 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.
Persistent Identifierhttp://hdl.handle.net/10722/188556
ISSN
2015 Impact Factor: 1.329
2015 SCImago Journal Rankings: 0.497
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorZhang, GGen_US
dc.contributor.authorBausell, Ben_US
dc.contributor.authorLao, Len_US
dc.contributor.authorLee, WLen_US
dc.contributor.authorHandwerger, Ben_US
dc.contributor.authorBerman, Ben_US
dc.date.accessioned2013-09-03T04:10:15Z-
dc.date.available2013-09-03T04:10:15Z-
dc.date.issued2004en_US
dc.identifier.citationAlternative Therapies In Health And Medicine, 2004, v. 10 n. 1, p. 58-63en_US
dc.identifier.issn1078-6791en_US
dc.identifier.urihttp://hdl.handle.net/10722/188556-
dc.description.abstractContext • 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.en_US
dc.languageengen_US
dc.publisherInnoVision Communications. The Journal's web site is located at www.alternative-therapies.comen_US
dc.relation.ispartofAlternative Therapies in Health and Medicineen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshArthritis, Rheumatoid - Diagnosis - Therapyen_US
dc.subject.meshClinical Competenceen_US
dc.subject.meshDiagnosis, Differentialen_US
dc.subject.meshDrugs, Chinese Herbal - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMarylanden_US
dc.subject.meshMedicine, Chinese Traditional - Utilizationen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPhysical Examination - Standardsen_US
dc.subject.meshPilot Projectsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshQuality Assurance, Health Careen_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshResearch Designen_US
dc.titleThe variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patientsen_US
dc.typeArticleen_US
dc.identifier.emailLao, L: lxlao1@hku.hken_US
dc.identifier.authorityLao, L=rp01784en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid14727501-
dc.identifier.scopuseid_2-s2.0-0348049534en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0348049534&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume10en_US
dc.identifier.issue1en_US
dc.identifier.spage58en_US
dc.identifier.epage63en_US
dc.identifier.isiWOS:000187675900009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridZhang, GG=7405272323en_US
dc.identifier.scopusauthoridBausell, B=6506485731en_US
dc.identifier.scopusauthoridLao, L=7005681883en_US
dc.identifier.scopusauthoridLee, WL=7407085578en_US
dc.identifier.scopusauthoridHandwerger, B=7003457500en_US
dc.identifier.scopusauthoridBerman, B=35458606800en_US

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