Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

Application of Caenorhabditis elegans in screening active ingredients of traditional Chinese medicine

People continue to recognize the important role of Chinese medicine in the treatment of diseases,and there is an urgent need to clarify the mechanism of Chinese medicine.Because of the multi-target and multi-component characteristics of traditional Chinese medicine,it is difficult to elaborate from a single perspective.As a high-quality animal model,Caenorhabditis elegans with the characteristics of small size and fast reproduction,has been widely used in traditional Chinese medicine activity experiments.In this article,Caenorhabditis elegans,as model organisms used to screen the active components of traditional Chinese medicine were reviewed.

Teaching Reform of “Nursing of Traditional Chinese Medicine” Course Based on OBE Concept

Traditional Chinese medicine(TCM)nursing is one of the important disciplines in TCM.It is based on TCM theory and combined with modern nursing theory and technology,aiming to provide comprehensive and individualized nursing services.With the changes in the medical environment and the continuous improvement of people’s health needs,the teaching of TCM nursing is facing new challenges and opportunities.This paper aims to discuss the teaching reform of TCM nursing course based on the concept of outcome-based education(OBE)or student-centered teaching.The significance of this study is to provide theoretical basis and practical guidance for the teaching reform of TCM nursing course,and to promote the development and progress of TCM nursing education.Through the teaching reform based on OBE concept,we can better cultivate TCM nursing talents with innovative spirit and practical skills,and contribute to the development of TCM.

Effects of Traditional Chinese Herbal Medicine on Immune Organ Indexes and Macrophages Phagocytic Indexes in Chickens Infected by Infectious Bronchitis Virus

[ Objective] To study the therapeutic effects of traditional Chinese medicine prescriptions on infectious bronchitis （IB） and find a novel avenue for prevention and treatment of viral diseases in poultry. [Method] A total of 160 cockerels at the age of 15 d were divided into four groups randomly, including traditional Chinese medicine group, moroxydine control group, challenge control group and healthy control group. Except the healthy control group, other groups were challenged with infectious bronchitis virus （IBV） on Day 15. After 48 h post challenge, the traditional Chinese medicine groupand moroxydine control group were respectively administrated with Chinese herbal medicine prescription and moroxydine, continuously for 5 d. The immune organ indexes and macrephage phagocytic indexes were detected on Day 18, 24 and 30, respectively. [ Result] The immune organ indexes and macrophage phagocytic indexes were not significantly different between traditional Chinese medicine group and moroxydine control group on Day 18. But all the indexes of the traditional Chinese medicine groups were increased significantly （ P 〈 0.05） on Day 24 and 30, and showed extremely significant difference （ P 〈 0.01 ） with those of challenge control group on Day 30. [ Conclusion] The traditional Chinese herbal medicine can enhance macrophage phagocytic indexes and immune organs indexes of chickens infected by IBV.

The Foundation of Traditional Chinese Medicine

In this paper, the authors examine and interpret the concept of Traditional Chinese Medicine (TCM) whom the Chinese believes and practices for so many centuries. The authors also explain the ancient Chinese con-cepts of Chi and Tao (Yin and Yang) which are the foundation of the TCM. This paper also seeks to discuss the ways of attaining a healthy body with the clarity of mind as well as to demonstrate the benefits of such healthy lifestyle.

Organic Integration of Traditional Chinese and Western Medicines—Future of Clinical Practice Guidelines of Integrated Traditional Chinese and Western Medicines

The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.

Treatment of Chinese traditional medicine wastewater in a submerged membrane bioreactor

A pilot scale test was conducted in a submerged membrane bioreactor SMBR with capacity of 10.0 m3/d for 120 days to treat high-strength Chinese traditional medicine wastewater. Performance of the SMBR was investigated with a sludge retention time (TSR) of 50 days, a hydraulic retention time (THR) of 8.0 h, membrane flux of 8.0 L/(m2·h) and dissolved oxygen (DO) concentration of 2.0-3.0 mg/L, respectively. It was observed that the SMBR had high capacity of COD and suspended solid (SS) removal. The influent COD concentration was fluctuated between 1 000 and 5 000 mg/L, while the averaged effluent COD concentration was only 44.6 mg/L. The influent SS concentration was fluctuated between 1 000 and 1 600 mg/L, while little effluent SS was detected. It was found that the COD remove rate increased with mixed liquor suspended solids (MLSS) and organic loading rate (ROL). In order to obtain good-quality effluent, the operational conditions of the SMBR were suggested as follows: the temperature was controlled above 10 ℃, MLSS about 7000 mg/L, ROL under 24.76 kg/(m3·d), low vacuum value and constant water flux.

脓毒症中医证型分布、死亡因素分析及AT-Ⅲ联合NT-proBNP、SOFA评分对预后的评估价值

目的:探讨脓毒症中医证型分布规律及影响脓毒症患者预后的因素,并分析抗凝血酶原-Ⅲ(AT-Ⅲ)、N-末端脑钠肽前体(NT-proBNP)及序贯性器官衰竭(SOFA)评分对脓毒症患者预后的评估价值。方法:选取148例脓毒症患者作为研究对象,总结中医证型分布规律。根据预后情况分为存活组115例及死亡组33例。通过单因素及多因素逻辑(logistic)回归分析影响脓毒症患者预后的相关因素。绘制受试者工作特征(ROC)曲线评价AT-Ⅲ、NT-proBNP及SOFA评分对其预后的评估价值。结果:148例脓毒症患者的中医证型分布按频次从高到低排序依次为急性虚证64例(43.24%)、毒热证35例(23.65%)、血瘀证31例(20.95%)、腑气不通证18例(12.16%)。死亡组患者中急性虚证比例高于存活组(P<0.05)。急性虚证、AT-Ⅲ降低、NT-proBNP升高、SOFA评分、男性均为脓毒症患者死亡的危险因素(P<0.05)。AT-Ⅲ、NTproBNP、SOFA评分预测脓毒症患者死亡的ROC曲线下面积分别为0.676、0.715、0.724。当三者联合诊断时,ROC曲线下面积提高到0.8,敏感度高达90.9%。结论:脓毒症中医证型分布依次是急性虚证、毒热证、血瘀证和腑气不通证,急性虚证、AT-Ⅲ降低、NT-proBNP升高、SOFA评分、男性均为脓毒症患者死亡的危险因素。AT-Ⅲ联合NT-proBNP及SOFA评分可有效提升脓毒症患者死亡的早期预测准确性。

论中医治疗急危重症之临床理念

中医急诊重症医学是一门新兴学科,本文结合古代医籍论述及当今临床实践,总结了中医救治急危重症的5个理念:救命留人之“整体观”;祛除病因之“病因论”;明辨虚实之“正邪论”;动态观察之“恒动观”;已病防变之“未病论”。救命留人之“整体观”是战略层面的,在急危重症的救治中要贯穿始终;祛除病因之“病因论”和明辨虚实之“正邪论”是战术层面的,关乎具体治疗方案的制订;动态观察之“恒动观”,是在治疗方案初步确定,动态观察病情变化,随时评估治疗效果,反馈修正治疗方案;而已病防变之“未病论”,则是我们通过以上4个理念的坚持,所应达到的理想状态。

浙派中医治疗痛经经验整理

[目的]总结1911年前浙派中医治疗痛经的经验,探究其特色。[方法]对浙派中医古籍文献中有关痛经的论述、病案等进行摘录整理,总结痛经病机及治疗特色。[结果]浙派中医治疗痛经以“气血失调”为主要病机,提倡以寒热虚实为纲的气血辨证法,从月经有无先后失期、经血色量如何、痛在经行前后三方面进行辨证。文献所记载的痛经证型共8种,分别为血气虚证、血虚有滞证、血虚有寒证、血虚有热证、冲任不足证、肝气郁滞证、气滞血瘀证、寒凝血瘀证,以“温通清化、调和血气”为治则。浙派中医发扬命门学说,擅用温药,记载痛经要药10味,分别为凌霄花、白芍、马鞭草、玄胡、京三棱、鹿角、阳起石、白头翁根、莲房、荷叶。[结论]浙派中医治疗痛经从“气血”立论,“温补”“清化”以治本,“调畅气血”为根本,以辨证论治、治病求本为宗。

基于“五寓”课程思政理念的中医药人才培养策略研究——以“中药炮制学专论”课程为例

中药学类研究生课程重视中药学思维的培养,具有课程思政挖掘的良好基础,但课程思政缺乏系统设计,思政教育与专业教育融入未形成长效机制,专业课程考核和评价欠缺“课程思政”相关指标,“两张皮”问题仍然存在.为此以“中药炮制学专论”课程为例,课程团队践行“五寓”课程思政理念,通过对教学内容进行重构,改进教学方法,拓宽教育场域,实现思政目标与知识目标、能力目标和素质目标“同频共振”.“五寓”课程思政理念的凝练针对性地解决了研究生课程思政教与学中的问题,为中药学学科课程思政建设提供了保障.

多重思维交汇下中医本科课程一体化内涵建设探索

随着全球一体化发展下的学科交叉与融合,教学一体化建设的优势作用逐渐显现。本科教学质量的提升,既要保持传统优势,又要紧随时代的发展有所创新,不仅要有形式上的整体性,更要挖掘知识内涵的一体化发展。中医本科教学体系通过中医学“整体观念”引导学科融合,能够恢复知识体系的整体性。以中西方各具优势和特色的思维模式,辨证选择以多种不同教学思维和方法,能够更加精准对焦教学内容的外在表达。因此,中西贯通,多重思维优势互补,是中医本科课程一体化建设的创新,是突破固有模式、深化内涵建设的教学新探索。

肿瘤患者呼吸道多重耐药菌感染中医证型及易感因素研究

【目的】探讨呼吸道多重耐药菌感染肿瘤患者的中医证候分布特点及易感因素。【方法】采用病例对照研究方法,以痰细菌培养阳性的250例呼吸道多重耐药菌感染肿瘤患者为多耐组,以痰细菌培养阳性的250例呼吸道非多重耐药菌感染肿瘤患者为对照组,收集2组患者的年龄、性别、临床相关检查结果及既往抗菌药物使用状况等临床资料,分析呼吸道多重耐药菌感染肿瘤患者的中医证候分布特点和易感因素。【结果】(1)易感因素方面:单因素分析结果提示,2组间的高血压史、糖尿病史、冠心病史、化疗周期、抗菌药物使用时间、白蛋白、血红蛋白比较,差异均有统计学意义(P<0.05或P<0.01);多因素Logistic回归分析结果提示,以上变量均是肿瘤患者呼吸道多重耐药菌感染的危险因素,差异均有统计学意义(P<0.05或P<0.01)。(2)病原菌分布方面:肿瘤患者呼吸道多重耐药菌感染最常见致病菌排前3位的依次为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌。(3)中医证候分布方面:实证方面,多耐组痰浊阻肺、热陷心包、痰热蕴肺的证型表现均较对照组严重,差异均有统计学意义(P<0.05或P<0.01);虚证方面,多耐组脾肾两虚、肺肾两虚、肝肾阴虚及心肾阳虚的证型表现均较对照组严重,差异均有统计学意义(P<0.05或P<0.01)。【结论】合并基础病、化疗周期长、抗菌药物使用时间长、低水平白蛋白及低血红蛋白为肿瘤患者发生呼吸道多重耐药菌感染的危险因素;相对于非多重耐药菌感染肿瘤患者,多重耐药菌感染肿瘤患者病情较重,中医证型以虚实夹杂型为主,而非多重耐药菌感染肿瘤患者以实证居多。

成果教育导向理念下思维导图在康复专业课程群中的教学研究与实践策略

成果教育导向(OBE)理念由美国教育学家首先提出,经过不断地发展,形成了比较完整的理论体系,贯穿于教育认证标准的始终。《中医康复学》《物理治疗学》《肌肉骨骼康复学》《运动医学》等课程是辽宁中医药大学中医康复学专业、康复治疗学专业的核心课程,具有专业性强、实践知识丰富、技能操作多样化等特点。基于OBE理念可以将该课程教学的特点与思维导图有机融合,真正实现以学生为中心,培养学生的自主学习能力,提高学生的学习兴趣,构建专业知识框架,形成自己的独立的知识体系,为将来走向社会,提高学生就业的竞争力打下基础。

墨子义利观视域下古代中医义利观分析及其当代价值

古代中医医家行医目的和取酬态度与墨子义利观具有高度相通性。在墨子“贵义尚利”思想的涵养和规约下,古代中医医家形成了以术利人、以义为先的行医目的和义利兼顾、以义获利的取酬态度。以古鉴今,将古代中医义利观的精髓,通过感染教育,培养医务人员以义为上的行医追求;利用课程思政和媒体宣传,鞭策医务人员守住以义制利的行医底线;借助激励机制,构建义利兼顾的薪酬分配等多种路径,有机融摄于当代医德义利观教育,以冀树立符合当今经济和社会发展的医学义利观,为构建和谐医患关系、促进医学健康发展、构建人类卫生健康共同体助力。

蝮蛇咬伤中医治疗优化方案的疗效评价

目的评价中医优化方案治疗蝮蛇咬伤的临床疗效。方法回顾研究蝮蛇咬伤住院患者资料,根据中医治疗方案的不同,将符合纳入标准的病例分为对照组87例、试验组82例,对照组采用未优化中医方案,试验组采用优化中医方案,2组均配合以西医常规治疗,比较2组治疗前后伤肢肿胀疼痛程度、症状与体征积分、炎症指标、脏器功能指标、治愈率、治愈时间。结果在伤肢肿胀疼痛程度及症状消失时间、症状与体征积分方面,试验组治疗效果较对照组更为显著(P<0.05);2组治疗后6 d,WBC、N%、CRP、ALT、AST、Cr、NGAL、CK-MB指标均降低(P<0.05),试验组CRP、ALT、AST、Cr、NGAL指标较对照组降低更明显(P<0.05),但在降低CK-MB方面,2组效果相当,无明显差异(P>0.05);治愈率方面:试验组(97.56%,80/82)显著高于对照组(88.51%,77/87)(P<0.05),治愈时间方面:试验组较对照组用时更短(P<0.05)。结论中医优化方案能快速缓解蝮蛇咬伤肢体肿痛及全身症状、减轻机体炎症反应、改善重要脏器功能,临床效果好,值得推广应用。

基于OBE教育理念运用SPOC联合CBL教学模式与单用SPOC教学模式在《中医急诊学》教学中的比较研究

目的探讨基于OBE教育理念下运用SPOC联合CBL教学模式与单用SPOC教学模式在《中医急诊学》教学中的效果比较。方法选择2021年9月—2022年2月成都中医药大学需修《中医急诊学》的中医学专业两个班级共82名学生作为研究对象,采用随机数表法将其随机分成2组,其中对照组41名,采用SPOC教学模式,观察组41名,采用SPOC联合CBL教学模式,通过理论考试成绩、病例分析成绩、教学满意度对两组学生进行教学效果评价。结果对照组理论考试成绩与观察组比较,差异无统计学意义(P>0.05),而观察组病例分析成绩明显高于对照组,差异有统计学意义(P<0.05),同时观察组教学满意度明显高于对照组,差异有统计学意义(P<0.05)。结论基于OBE教育理念运用SPOC联合CBL教学模式相对于SPOC教学模式,可显著提高学生分析与解决临床问题的能力,同时也是学生认可的学习方式,值得被广泛应用。

Progress of Research on Organic Fibrosis with Traditional Chinese Medicine

Fibrosis is the remodeling and repair processes of chronic injuries. There are few effective therapies. Chinese medicine formula, the main pattern of traditional Chinese medicine(TCM) in clinic, applies a multi-component, multi-target and complicated approach in the treatment of diseases, and certainly shows good comprehensive therapeutic effects on fibrosis. In this review, the clinical study, effects and mechanism of action of Fuzheng Huayu recipe in the treatment of liver, pulmonary, and renal fibrosis was analyzed and evaluated. Meanwhile, based on the understanding of TCM pathogenesis for liver cirrhosis, this review will also briefly introduce the research of different classical Chinese medicine formulae with various functions in the treatment of experimental liver fibrosis induced by different methods, including comparing the efficacy, analyzing the action characteristics and mechanism of effective formulae, exploring pathological and biological basis of TCM diagnostic and therapeutic pattern, which will contribute to the research of TCM in the treatment of organ fibrosis.

改善胰岛素抵抗类中药治疗机制研究进展

大多数2型糖尿病患者会出现胰岛素抵抗,中药具有多成分、多靶点、多通路、多生物途径综合作用的特点,能通过多种机制改善胰岛素抵抗,且无不良反应,但是机制研究不够深入。文章以胰岛素抵抗的发病机制以及中药改善胰岛素抵抗的作用机制为切入点,对近10年具有改善胰岛素抵抗作用的中药[包括单味中药、活性成分、复方(CCTM)]作用机制进行综述,发现胰岛素抵抗的发病机制涉及到因各种因素导致的胰岛素信号通路异常,在骨骼肌、肝脏、脂肪中主要与炎症、氧化应激引起的代谢紊乱有关,IRS-1/PI3K/Akt是以上途径的经典通路。无论中药单味药、中药有效成分、中药复方都能改善胰岛素抵抗,现有实验研究的治疗机制与改善胰岛素抵抗的经典发病机制有关,中药单味药、中药的有效成分研究是中药改善胰岛素抵抗的基础,随着研究的深入,未来中药复方在改善胰岛素抵抗的治疗方面有很大的潜力。