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Clinical reasoning in traditional medicine exemplified by the clinical encounter of Korean medicine
김태훈,Terje Alraek,Zhaoxiang Bian,Stephen Birch,Mark Bovey,Ju Ah Lee,Myeong Soo Lee,Nicola Robinson,Christopher Zaslawski 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2
Background: Clinical reasoning is generally defined to be a way of thinking for diagnostic or therapeutic decision making in clinical practice. Different cognitive models have been proposed for the clinical reasoning which takes place during the clinical encounter with a patient. This may have similarities with similar approaches used in Traditional Korean Medicine (TKM). Jinchal, the clinical encounter, has specific features in TKM and different Jinchal processes are closely related to several underlying cognitive models in clinical reasoning. It is a necessary process to see the patient, but in TKM, the method has a characteristic aspect and emphasis is placed on importance. Methods: Experts consensus were reached through panel discussion. Narrative description on the concept of clinical reasoning and explanation on Jinchal process in TKM were suggested. Results: This article analyses the Jinchal process using theoretical concepts from four authentic KM schools of clinical reasoning which are currently used in contemporary practice. Conclusion: Future research should focus on the similarities and differences in understanding clinical reasoning in KM as well as the broader field of traditional East Asian Medicine.
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Hong-Yan Qin,Kai-hong Zang,Xiao Zuo,Xin-An Wu,Zhaoxiang Bian 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.7
Intestinal enterochromaffin (EC) cell hyperplasia and increased 5-hydroxytryptamine (5-HT) availability play key roles in the pathogenesis of abdominal hypersensitivity of irritable bowel syndrome (IBS). This study aims to study the effect of quercetin on visceral pain and 5-HT availability in postinflammatory IBS (PI-IBS) rats. PI-IBS model rats were administered quercetin by gavage at doses of 5, 10, and 20 mg/kg for 14 days. Compared with normal rats, the visceral pain threshold of PI-IBS rats was markedly decreased and the abdominal motor response to colon distension was markedly increased. The EC cell count and 5-HT level, as well as tryptophan hydroxylase (TPH) protein, were all significantly elevated in PI-IBS rats, while the 5-HT reuptake transporter (serotonin transporter) was reduced. Genes that are responsible for enteroendocrine cell differentiation, that is, Ngn3 and pdx1, were significantly increased in the PI-IBS group. Quercetin treatment markedly elevated the pain threshold pressure and decreased the visceral motor response of PI-IBS animals; and EC cell density and 5-HT level, as well as TPH expression, in the PI-IBS group were all reduced by quercetin. Quercetin treatment also significantly reduced colonic expression of Ngn3 and pdx1 of PI-IBS. Findings from the present study indicated that the analgesic effect of quercetin on PI-IBS may result from reduction of 5-HT availability in the colon, and the regulatory role of quercetin in endocrine progenitors may contribute to reduced EC cells.
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Li Zhang,Xiaoyun Chen,Yanqi Cheng,Qilong Chen,Hongsheng Tan,Dongwook Son,Dongpill Chang,Zhaoxiang Bian,Hong Fang,Hongxi Xu 고려인삼학회 2019 Journal of Ginseng Research Vol.43 No.4
Background: Korean Red Ginseng (KRG) is widely used for strengthening the immune system andfighting fatigue, especially in people with deficiency syndrome. However, there is concern that the longtermapplication or a high dose of KRG can cause “fireness” (上火in Chinese) because of its “dryness” (燥性in Chinese). The aim of this study was to assess the safety and efficacy of a 4-week treatment with KRGin participants with deficiency syndrome. Methods: This was a 4-week, randomized, double-blind, placebo-controlled clinical trial. A total of 180Chinese participants were randomly allocated to three groups: placebo control group, participants weregiven a placebo, 3.6 g/d; KRG 1.8 g and 3.6 g groups. The primary outcomes were the changes in firenessand safety evaluation (adverse events, laboratory tests, and electrocardiogram). The secondary outcomeswere the efficacy of KRG on fatigue, which include the following: traditional Chinese medicine (TCM)symptom scale and fatigue self-assessment scale. Results: Of the 180 patients, 174 completed the full study. After 4 weeks of KRG treatment, the Fire-heatsymptoms score including Excess fire-heat score and Deficient fire-heat score showed no significantchange as compared with placebo treatment, and no clinically significant changes in any safetyparameter were observed. Based on the TCM syndrome score and fatigue self-assessment score, TCMsymptoms and fatigue were greatly improved after treatment with KRG, which showed a dose- and timedependenteffect. The total effective rate was also significantly increased in the KRG groups. Conclusion: Our study revealed that KRG has a potent antifatigue effect without significant adverse effectsin people with deficiency syndrome. Although a larger sample size and longer treatment may berequired for a more definite conclusion, this clinical trial is the first to disprove the common conceptionof “fireness” related to KRG.
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Zhang, Li,Chen, Xiaoyun,Cheng, Yanqi,Chen, Qilong,Tan, Hongsheng,Son, Dongwook,Chang, Dongpill,Bian, Zhaoxiang,Fang, Hong,Xu, Hongxi The Korean Society of Ginseng 2019 Journal of Ginseng Research Vol.43 No.4
Background: Korean Red Ginseng (KRG) is widely used for strengthening the immune system and fighting fatigue, especially in people with deficiency syndrome. However, there is concern that the long-term application or a high dose of KRG can cause "fireness" (上火 in Chinese) because of its "dryness" (燥性 in Chinese). The aim of this study was to assess the safety and efficacy of a 4-week treatment with KRG in participants with deficiency syndrome. Methods: This was a 4-week, randomized, double-blind, placebo-controlled clinical trial. A total of 180 Chinese participants were randomly allocated to three groups: placebo control group, participants were given a placebo, 3.6 g/d; KRG 1.8 g and 3.6 g groups. The primary outcomes were the changes in fireness and safety evaluation (adverse events, laboratory tests, and electrocardiogram). The secondary outcomes were the efficacy of KRG on fatigue, which include the following: traditional Chinese medicine (TCM) symptom scale and fatigue self-assessment scale. Results: Of the 180 patients, 174 completed the full study. After 4 weeks of KRG treatment, the Fire-heat symptoms score including Excess fire-heat score and Deficient fire-heat score showed no significant change as compared with placebo treatment, and no clinically significant changes in any safety parameter were observed. Based on the TCM syndrome score and fatigue self-assessment score, TCM symptoms and fatigue were greatly improved after treatment with KRG, which showed a dose- and time-dependent effect. The total effective rate was also significantly increased in the KRG groups. Conclusion: Our study revealed that KRG has a potent antifatigue effect without significant adverse effects in people with deficiency syndrome. Although a larger sample size and longer treatment may be required for a more definite conclusion, this clinical trial is the first to disprove the common conception of "fireness" related to KRG.
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