Evidence-based Clinical Chinese Medicine:What Has Changed Over the Past 20 Years

Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.

基于人工神经网络的中医证治模型探析

传统中医的学习必须藉由跟从老师旁边跟诊的方式,才能学习到名老中医的经验与精华,但在讲求效率以及尊师重道薄弱的年代,这也让中医的传承更为困难,本研究尝试以类神经网络的信息技术,建立符合名老中医方证对应经验的自动诊疗系统。研究的结果显示,以C#.NET程序语言结合神经网络技术,开发出中医方剂处方系统与中医方证医学诊疗系统,系统可以快速收敛,并正确推算出相关的正确处方。研究所建立的人工智能诊疗系统,可以将名老中医的经验与精华,经由萃取而传承下来,这不失为除了跟诊学习外的另一种中医经验之传承方式。

Modulation by anti-oketsu formulations in Kampo medicine of human arterial stiffness

Objective:In traditional herbal medicine(Kampo medicine in Japan),'sho'is diagnosed by the traditional assessments of clinical conditions.Among a variety of the shos,there is an'oketsu'syndrome,which is a stagnation and disturbance of microcirculation.The prompt effects of four anti-oketsu formulations in Kampo medicine on cardiovascular functions were compared in oketsu and non-oketsu persons.Methods:The arterial pulse wave from radial artery is formed by the combination with ejection and reflection pulses.An augmentation index(AI),a ration of the ejection and reflection pulses,indicates a degree of arteriosclerosis.For both seventy-six students with oketsu and thirty-seven students with non-oketsu,Kampo formulations overcoming oketsu of Tokishakuyakusan(TS,Dang-Gui-Shao-Yao-San),Kamishoyosan(KS,Jia-Wei-Xiao-Yao-San),Keisibukuryogan(KB,Gui-Zhi-Fu-Ling-Wan)and Tokakujokito(TJ,Tao-He-Cheng-Qi-Tang)were taken once,and then,the cardiovascular functions including blood pressure,heart rate,central arterial blood pressure(CBP)and AI were examined for 60 min.Results:At 40-60 min after an intake,these formulations decreased the AI almost by 6-18%(n=76),by 18.3±3.1%(P<0.01,n=15)with TJ.Simultaneously,the CBP was reduced by 9.0±1.8%(P<0.05,n=23)with KS and by 9.1±2.0%(P<0.05,n=15)with TJ.On the other hands,non-oketsu group had less or no effect by any kinds of the formulations.Conclusion:The anti-oketsu formulations can exert the ameliorative action for oketsu persons via decreasing AI and CBP.

Issuing the Antibiotics for Children with and without Prescription in Pharmacies in Republic of Macedonia

The use of medicines for infants and children is presenting one unique set of challenges, because children are the most vulnerable population in any society. In this study, we set out to present the characteristics and classification of antibiotics recommended for children according to WHO, EMA and EBM. Also, the aim of this study was to analyze the most prescribed pediatric antibiotics in 2013 in Republic of Macedonia compared with standard treatments. Presented data was collected according to the number of prescribed recipes of pediatric dosage forms covered by the Fund of Republic of Macedonia. The obtained results showed that the most prescribed pediatric antibiotic is amoxicillin with clavulanic acid （875mg ＋ 125mg） in form of tablet, with 280 863 prescribed recipes which corresponds to the recommendations of EBM.

Solution of nonlinear cubic-quintic Duffing oscillators using He’s Energy Balance Method

In this study, He＇s Energy Balance Method （EBM） was applied to solve strong nonlinear Duffing oscillators with cubic-quintic nonlinear restoring force. The complete EBM solution procedure of the cubic-quintic Duffing oscillator equation is presented. For illustration of effectiveness and convenience of the EBM, different cases of cubic-quintic Duffing oscillator with different parameters of α,β and y were compared with the exact solution. We found that the solutions were valid for small as well as large amplitudes of oscillation. The results show that the EBM is very convenient and precise, so it can be widely appli- cable in engineering and other sciences.