Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

Traditional Chinese Medicine as a Treatment for Rheumatoid Arthritis:From Empirical Practice to Evidence-Based Therapy

Rheumatoid arthritis(RA)is a common autoimmune condition with an elusive etiology.Conventional and biological disease-modifying drugs sometimes fail or produce only partial responses.Traditional Chinese medicine(TCM)has long been used in China as a treatment for RA and is achieving everincreasing acceptance worldwide.TCM treatments are traditionally guided by the theory of treatment based on TCM syndrome differentiation;however,they remain a matter of empirical practice relying on TCM theories and doctors’own experience,which places severe restrictions on worldwide TCM application.Nevertheless,TCM is a treasure trove for drug discovery,particularly as a treatment for complicated human conditions.The discoveries of artemisinin as a treatment for malaria and of TCM–arsenic trioxide(As2O3)combination therapy as a treatment for acute promyelocytic leukemia(APL)are excellent examples of the great value of TCM.Regarding RA treatments,many Chinese medicinal herbs and their formulas,extracts,ingredients,and even single compounds have been used in clinical applications.Several Chinese proprietary medicines(CPMs)derived from TCM formulas or herbal bioactive components,such as the controlled-release ZhengQingFengTongNing(ZQFTN)Tablets,Tripterygium Glycoside Tablets,and Total Glucosides of Peony(TGP)Capsules,have been included in the National Health Insurance Directory of China,and show comparable therapeutic efficacies to those of western chemical drugs with fewer side effects.As TCM research has advanced,particularly in the use of multidisciplinary technologies,the scientific foundations and characteristics of the use of TCM to treat RA have been revealed,and the quality of TCM treatments have been increasingly enhanced.However,TCM generally lacks sufficient clinical and laboratory data to be consistent with international standards for quality,safety,and efficacy in order to support its application worldwide.Therefore,intensive basic and clinical studies on TCM are required.In particular,investigations that use cutting-edge technologies in analytical chemistry,biology,and biomedical sciences,and the development of randomized clinical trials(RCTs)and personalized pragmatic randomized controlled trials(PPRCTs)are necessary.Researchers should also collaborate to advance TCM from empirical practice to evidence-based therapy,thus consistently promoting TCM development and globalization in a vital,beneficial,and contributable manner.

Promoting integrative medicine by computerization of traditional Chinese medicine for scientific research and clinical practice: The SuiteTCM Project

BACKGROUND： Chinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine （TCM） is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy. METHODS： We proposed the development of the SuiteTCM software, a collection of integrated computational models mainly derived from epidemiology and statistical sciences for computerization of Chinese medicine scientific research and clinical practice in all levels of prevention. The software includes components for data management （DataTCM）, simulation of cases （SimTCM）, analyses and validation of datasets （SciTCM）, clinical examination and pattern differentiation （DiagTCM, TongueTCM, and PulseTCM）, intervention selection （AcuTCM, HerbsTCM, and DietTCM）, management of medical records （ProntTCM）, epidemiologic investigation of sampled data （ResearchTCM）, and medical education, training, and assessment （StudentTCM）. DISCUSSION： The SuiteTCM project is expected to contribute to the ongoing development of integrative medicine and the applicability of TCM in worldwide scientific research and health care. The SuiteTCM 1.0 runs on Windows XP or later and is freely available for download as an executable application.

A brief overview of traditional Chinese medicine prescription powered by artificial intelligence

Traditional Chinese medicine prescription is one of the treasures of traditional Chinese medicine(TCM).There are tens of thousands TCM prescriptions accumulated in the past thousands of years,corresponding to different diseases,symptoms and therapeutic goals.The correspondences are so complicated that there is an urgent need to leverage new technologies such as artificial intelligence(AI)to analyze,understand and utilize them effectively.In this paper,we present a brief overview of this direction,where current research progress on TCM prescription powered by AI is summarized.Our summarization focuses on three aspects,TCM prescription mining that aims at understanding the TCM prescription,TCM prescription or herb knowledge base construction that aims at extracting knowledge to support the TCM prescription-related study,and TCM prescription discovery that aims at utilizing AI technologies to further energize TCM.It is encouraging to see that steady progress in this direction has been made recently.Besides,a toy experiment on image-based TCM herb recognition by using convolutional neural networks is also conducted.It basically verifies that it is promising to use AI technologies to address challenging tasks in TCM.We also point out several research topics that could be cooperatively performed by researchers from the two disciplines.

Drug Deslgn Based on Chinese Traditional Medicine

There are two new trends in the development of novel Pharmaceuticals. Biotechnology provides a novel approach to rational drug design. At the same time, there has been a growing interest in the use of herbal products. Chinese medical herbs are rich in the natural resources and have been used for thousands years in China. We consider the Chinese medicine system as a natural combinatorial chemi-

The combination of disease and Zheng (syndrome) on the basic of differentiation of six channels:a new pattern of disease diagnosis and treatment of traditional Chinese medicine

Traditional Chinese medicine(TCM)was formed two thousand years ago,and developed in the following centuries.TCM has a unique way of looking at health and illness.Zheng(syndrome)is the basic unit and key term in TCM theory.Zheng is the pathological generalization of a certain stage in the development of disease.Treatment based on syndrome differentiation and disease differentiation of TCM is the basic principle to know and treat diseases,and a kind of special method to study diseases in TCM.In Han Dynasty(200 AD),doctor Zhang Zhongjing proposed Liujing Bianzheng(the differential diagnosis in accordance with the theory of six channels)to diagnose and treat diseases in Treatise on Febrile and Miscellaneous Diseases.In other words,he divided diseases into six channels diseases based on patient's Zhengs.Six channels diseases almost include all of the disease according to his classification standards.In addition,there are development rules in the progress of six channels diseases.Therefore,we hypothesized that combination of six channels disease and Zheng on the basic of differentiation of six channels is a new pattern of diagnosis and treatment diseases in TCM,which is beneficial to the understanding of a certain disease and makes disease treatment more convenient,fast and effective.

Traditional Chinese medicine combined with low-dose glucocorticoid for treating nephrotic syndrome: A case report

Nephrotic syndrome(NS)is a common refractory clinical disease that can develop into end-stage renal disease(ESRD)if cannot be controlled.At present,in Western medicine,glucocorticoid or immunosuppressant drugs with heavy dose and long course are used for the therapy of NS.There are still few reports on the combined treatment of traditional Chinese medicine and low-dose glucocorticoid for NS.Here,we reported a case of a 48-year-old man diagnosed with NS,accompanied by severe pulmonary infection,abundant proteinuria,and pleural effusion.Integrated traditional Chinese and Western medicine was used as the therapeutic regimen of this patient.Traditional Chinese medicine(TCM)mainly focused on invigorating spleen and kidney,promoting blood circulation,removing blood stasis and promoting diuresis,and Chinese patent medicines or TCM immunosuppressants were given to consolidate the treatment.In Western medicine,small dose and short course glucocorticoids combined with symptomatic treatment were adopted.Delightfully,proteinuria subsided after 5 months treatment with integrated TCM and Western medicine and all laboratory reports were negative after 10 months,which has been normal so far(July 2019).This case report indicates that the combination of TCM and low-dose glucocorticoid is effective in curing NS,with low recurrence rate and few side effects.

Evidence-Based Medicine Research on Prescriptions in Synopsis of the Golden Chamber in the Treatment of Pelvic Inflammatory Disease

Purpose: Based on the National Natural Science Foundation of China, we collect and sort out the literature published in approximately the last 30 years, which use prescriptions in Synopsis of the Golden Chamber to treat pelvic inflammatory disease (PID). This study provides theoretical basis for the treatment of PID;we recommend this achievement to colleagues. Method: Firstly, we searched and collected the literatures from last three decades in CNKI, Wanfang and VIP databases, which are about classical prescriptions treating endometriosis. Then, by screening all the literatures, we obtained the clinical research literatures and individual case reports. Finally, we went through the internal quality of the two categories of literatures to get the dominant prescriptions. Using a retrospective study of evidence-based medicine research, we comprehensively collect literature, standardize the disease spectrum, classify the evidence, and then evaluate the internal quality. Results: We refine 4 prescriptions which commonly are used in the treatment of PID;in other words, they are also the clinical symptoms of PID: Gui Zhi Fu Ling Wan symptom, which manifests blood stasis and cold-damp stagnancy;Dang Gui Shao Yao San symptom, which manifests disharmony of liver and spleen, qi-blood stasis and damp obstruction;Da Huang Mu Dan Tang symptom, which manifests the gathering toxic heat and qi-blood stasis;Yi Yi Fu Zi Bai Jiang San symptom, which manifests the internal toxic heat and qi-blood injury. Conclusion: This study is gospel for the patients with recurrent episodes of PID who can’t often use antibiotics. At the same time, it is also a green therapeutics which Chinese ancients dedicated to human medicine.

Network toxicology and LC-MS-based metabolomics:New approaches for mechanism of action of toxic components in traditional Chinese medicines

Network toxicology combined with metabonomics is of great significance for the study of the toxic mechanism and prediction of toxicity of traditional Chinese medicines(TCMs).In this study,we reviewed the application of network toxicology based on LC-MS metabolomics,mainly in the study of toxic components and the toxicity mechanism of TCMs,which provides new ideas and methods for the further study of the toxicity mechanism of TCMs.

中西医结合诊治妊娠胚物残留专家共识(2024年版)

妊娠胚物残留(RPOC)是指流产或分娩后,胚胎组织或胎盘未能完全排出而残留子宫内,可引起出血、感染,甚至宫腔粘连等。目前RPOC的治疗策略主要分为药物治疗和手术治疗两类,但国内外对此尚未形成科学、规范的指导意见。中西医联合诊治一直是我国诊治RPOC的特色手段,为推广中西医结合协同诊疗理念,促进RPOC中西医结合诊疗技术发展,山东中医药学会妇科专业委员会、山东中西医结合学会生殖外科专业委员会、山东省疼痛医学会妇产科专业委员会共同牵头成立共识专家组,讨论形成《中西医结合诊治妊娠胚物残留专家共识(2024年版)》,从RPOC的高危因素、临床表现、诊断、治疗等方面阐述中西医结合协同诊疗理念,并提供专家共识,以改善RPOC患者预后,提高其生活质量。

雨课堂结合CBL教学模式在中医骨伤科的应用

目的探索中医骨科临床教学运用雨课堂结合基于案例的学习(CBL)教学模式的效果。方法选取广西中医药大学中医骨伤科2021级108名本科生,以随机编号的方式分为实验组和对照组,每组54人。实验组应用雨课堂结合CBL教学法,对照组应用传统教学模式,两组授课教师和教材均相同。教学结束后,比较两组考核成绩及教学满意度。结果实验组考核成绩及满意度调查评分均高于对照组,差异均有统计学意义(P<0.05)。结论雨课堂结合CBL教学模式是一种能够有效提高中医骨伤科课堂参与度,激发学生学习兴趣,提升学生综合能力的方法。

循证中医药研究的几个关键问题

循证医学历经30多年的发展取得了突出成效,深刻影响全球医药学发展的方方面面。循证医学强调临床相关决策要基于当前可得最佳证据,强调对证据的评价运用,推动了高质量证据生产与转化系列方法学的进步,对中医药临床疗效评价与国际接轨产生了良好推动作用。中医药循证评价研究不仅要遵循国际通行规则,还要符合中医药自身特点和需求。对中医药证据生产转化涉及的几个底层方法学问题,包括临床价值定位、科学测量、公平比较和高效转化等方面进行了探讨,供同道参考。

应用型人才培养模式下中药生物技术课程教学改革新路径

在应用型人才培养模式下,以中药资源与开发专业核心课程中药生物技术为例,从转变教学理念、重塑教学目标、创新教学方法、突显人文素质、改善评价机制方面着手,提出教学改革新路径。通过课程改革,能够改善课堂教学现状,打通理论与实践的界限,增强学生自主学习意识,提高终身学习能力,培养出新医科背景下能够更好地服务地方、服务基层、服务少数民族地区的一流应用型中药人才。

Clinical research of traditional Chinese medicine in big data era

With the advent of big data era, our thinking, technology and methodology are being transformed. Data-intensive scientific discovery based on big data, named ＂The Fourth Paradigm,＂ has become a new paradigm of scientific research. Along with the development and application of the Internet information technology in the field of healthcare, individual health records, clinical data of diagnosis and treatment, and genomic data have been accumulated dramatically, which generates big data in medical field for clinical research and assessment. With the support of big data, the defects and weakness may be overcome in the methodology of the conventional clinical evaluation based on sampling. Our research target shifts from the ＂causality inference＂ to ＂correlativity analysis.＂ This not only facilitates the evaluation of individualized treatment, disease prediction, prevention and prognosis, but also is suitable for the practice of preventive healthcare and symptom pattern differentiation for treatment in terms of traditional Chinese medicine （TCM）, and for the post-marketing evaluation of Chinese patent medicines. To conduct clinical studies involved in big data in TCM domain, top level design is needed and should be performed orderly. The fundamental construction and innovation studies should be strengthened in the sections of data platform creation, data analysis technology and big-data professionals fostering and training.

Nursing Based on Syndrome Differentiation Combined with Auricular Plaster Therapy in Alleviating Insomnia

Objective:To observe the effect of auricular point pressing combined with nursing based on syndrome differentiation in the treatment of insomnia patients.Methods:Totally 92 patients with insomnia were randomly divided into the observation groupgiven auricular point pressing combined with nursing care based on syndrome differentiation and the control group treated with auricular point pressing alone.The improvement of Pittsburgh Sleep Quality Index(PSQI),TCM Syndrome Score and nursing satisfaction were compared between the 2 groups.Results:The time effect of PSQI total score and 6 factors in both groups were statistically significant(P<0.05).The time effect,interaction effect and inter-group effect of subjective sleep quality,PSQI total score were statistically significant(P<0.05);the 4 inter-group factors of sleep quality,sleep latency,sleep duration and daytime function were statistically significant(P<0.05).The total score of TCM syndromes in the observation group was lower than that in the control group(P<0.05),and the satisfaction rate in the observation group higher than that in the control group(80.43%vs.60.86%,P<0.05).Conclusion:Auricular point pressing combined withnursing based on syndrome differentiation can effectively improve the sleep quality of insomnia patients,and has significant advantages in improving TCM syndromes,as well as gained higher nursing satisfaction from patients.

气交灸联合中药熏香对炎症性肠病患者睡眠障碍及炎性因子的影响

目的探讨气交灸联合中药熏香对炎症性肠病患者睡眠障碍及不良情绪、中医症候的改善效果。方法将101例心脾两虚型炎症性肠病睡眠障碍患者按时间段分为对照组51例和观察组50例,对照组采用常规护理及睡眠干预,观察组在对照组基础上实施4周气交灸联合中药熏香干预。结果干预后,观察组匹兹堡睡眠质量指数评分、多导睡眠监测指标得分、综合医院焦虑抑郁量表评分、中医症候积分、炎症因子水平显著优于对照组(均P<0.05)。结论气交灸联合中药熏香治疗可有效改善炎症性肠病睡眠障碍患者不良情绪及中医症状,降低炎症因子水平,提高睡眠质量。

基于BOPPPS线上线下混合式案例教学模式的中医诊断学教学探索

在分析中医院校中医诊断学课程定位及当前教学中存在的突出问题后,作者基于BOPPPS教学模型,创新性地将线上线下教学与案例教学相融合,采取课前线上线下教学、课中线下教学、课后线上师生交流和线下学生深入实践探寻问题相结合的模式,对提高学生学习积极性和学习效果进行探索。经初步实践证实,该教学模式能够激发学生的学习积极性与主动性,进一步提高学生的主体意识和自学能力,提高其四诊技能的综合运用能力和临床思辨能力,有效提高教学质量。因此,在中医诊断学课程教学中,基于BOPPPS教学模型的线上线下混合式案例教学模式为改善当前传统教学模式的不足提供了一种新的思路,值得研究及推广。

论基于“病、证、征结合”方剂的主治表述

目前对方剂主治的规范性研究较少,通过对方剂主治源流的梳理并分析《方剂学》教材中方剂主治描述中存在的问题,提出“病、证、征结合”3个层次的方剂主治描述规范,从而有利于临证依法用方、规范教材和规范方剂的科学研究。

从循证中医到智慧中医:自动系统评价技术和中医快速循证决策

循证中医从产生到发展极大推动了中医决策科学化和规范化,但传统证据产生模式无法满足快速循证决策需求。基于自动系统评价技术的中医药快速决策模式是智慧中医的典型案例,这种“端到端”循证决策模式在“中医药临床证据自动分析及可视化平台”得到验证。