When narrative medicine(NM)was introduced into China,traditional Chinese medicine scholars found that the core concepts advocated by NM are manifested in Chinese yi’an.But why NM echoes with ancient Chinese yi’an?Ho...When narrative medicine(NM)was introduced into China,traditional Chinese medicine scholars found that the core concepts advocated by NM are manifested in Chinese yi’an.But why NM echoes with ancient Chinese yi’an?How can we better integrate NM into Chinese medical practices?To answer those questions,this article first investigates how NM establishes itself as a remedy to biomedicine by taking traditional healing models including TCM as its ideal Other.Then,the narrative traditions of both case histories and yi’an are examined respectively.This article argues that NM is searching for a lost tradition of narrative case histories,but yi’an functions as a living tradition of TCM.The Parallel Chart in NM,designed as a complement to the dehumanized hospital chart,is still based on a dichotomy of science and art and a conflictual doctor-patient model.But yi’an exemplifies the holistic and humane healthcare that NM hopes to achieve.A comparison of both genres also inspired us to rethink the genre of yi’an in NM.Thus,it is concluded that yi’an should be viewed as an epistemic genre integrating individualization and generalization,a bridge linking medicine and literature.And narrative yi’an can well serve as a tool for NM in China.It is also proposed that a thick description of yi’an be encouraged to further promote a pluralistic NM in China.展开更多
Acne vulgaris is a chronic inflammatory skin disease damaging face,and the incidence of acne vulgaris is increasing year by year in China.Acne falls into the category of pimple in traditional Chinese medicine,and ther...Acne vulgaris is a chronic inflammatory skin disease damaging face,and the incidence of acne vulgaris is increasing year by year in China.Acne falls into the category of pimple in traditional Chinese medicine,and there are many dialectical understandings of acne in modern traditional Chinese medicine.Dr.He Aijuan has a unique diagnosis and treatment thinking in treating acne vulgaris(liver stagnation and spleen deficiency type)with traditional Chinese medicine in her clinical work for many years.Her application of Danggui Shaoyao Powder combined with Sini Powder has a remarkable effect in the clinical treatment process,so a clinical medical case is selected for discussion.展开更多
Objective:Dysmenorrhea is a common gynecological disease.Some severe symptoms affect the quality of life,causing physical and psychological discomfort.To analyze the dysmenorrhea cases of famous Senior traditional Chi...Objective:Dysmenorrhea is a common gynecological disease.Some severe symptoms affect the quality of life,causing physical and psychological discomfort.To analyze the dysmenorrhea cases of famous Senior traditional Chinese medicine(TCM)doctors and TCM masters through the data mining technology and explore core related rules between the symptoms,pathogenesis,coated tongue,pulse condition,so as to deeply deconstruct the law of TCM clinical differentiation and treatment of dysmenorrhea,verify the effectiveness of the law,and optimize the clinical TCM diagnosis and treatment scheme.Methods:The external correlation analysis of dysmenorrhea medical cases through the Medcase data processing platform and the algorithm of FP-Growth enhanced association analysis was applied.Results:Altogether 171 medical records were studied,which included 171 female patients and 483 clinical visits.The age of the oldest patient was 49,the age of the youngest was 14,the average age was 28 years old.The medical cases involoved 41 kinds of pathogenesis,147 clinical symptoms,16 types of pulse condition,84 types of coated tongue and 292 traditional Chinese medicine.The external correlation processing revealed that there were 25 groups of clinical symptoms and TCM association rules;17 groups of clinical symptoms and secondary TCM association rules;21 groups of pathogenesis and Chinese medicine association rules;34 rules of coated tongue and Chinese medicine association rules;19 rules of pulse condition and Chinese medicine association rules;28 rules of clinical symptoms and pathogenesis associations.Conclusion:When treating dysmenorrhea according to the differentiation and treatment of TCM,the viscera location of the core pathogenesis mainly are kidney,spleen and liver,the pathological factors focus on blood deficiency,blood stasis and qi stagnation.The highly-related TCM include Danggui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),Chuanxiong(Rhizoma Ligustici),Yanhusuo(Rhizoma Corydalis),Xiangfu(Rhizoma Cyperi).The study of these rules has reference value for the acquisition of the core pathogenesis,the clinical differentiation and the medication.展开更多
Objective: To analyze the similarities and differences of the applications of "the lung and large intestine being interior-exteriorly related"between the ancient and modern clinical practices, and to reveal ...Objective: To analyze the similarities and differences of the applications of "the lung and large intestine being interior-exteriorly related"between the ancient and modern clinical practices, and to reveal the theory meaning.Method: Based on the ancient and modern medical cases database, 245 ancient medical records and 373 modern medical records were studied with the general statistical description and analysis of association rules, and the results were compared to summarize the similarities and differences of the regular pattern of syndrome and treatment on lung-large intestine related diseases in ancient and modern medical records.Results: In modern medical cases, intestinal diseases appeared with the main symptom of constipation due to deficiency of lung qi and qi stagnation of large intestine were always treated by purgation together with replenishing and restoring lung qi. In ancient medical cases, large intestine heat was always caused by lung heat and a variety of diarrhea symptoms appeared. They were always treated by clearing heat and moistening lungs. In addition, the symptom of bound stool caused by qi stagnation of large intestine due to lung qi stagnation was always treated by lowering lung qi to regulate and smooth large intestine qi. And Armeniae Amarum Semen was used by both as a core medicinal herb.Conclusion: Ascending-descending of qi movement is the core of the lung and large intestine relationship. In other words, the lung and the large intestine communicate through qi.展开更多
Objective:To analyze misdiagnosis features in clinical cases of“Classified Medical Cases of Famous Physicians”and“Supplement to Classified Case Records of Celebrated Physicians.”Materials and Methods:Two hundred a...Objective:To analyze misdiagnosis features in clinical cases of“Classified Medical Cases of Famous Physicians”and“Supplement to Classified Case Records of Celebrated Physicians.”Materials and Methods:Two hundred and five ancient misdiagnosed cases were analyzed in aspects of locations(exterior-interior type,qi-blood type and Zang‑Fu organs type)and patterns(heat-cold type and deficiency-excess type)by Apriori Algorithm Method.Results:The main types of misdiagnosis in those medical casesare as follows::Zang‑Fu location misjudgment,misjudging the interior as the exterior,misjudging deficiency pattern as excess pattern,and misjudging cold pattern as heat pattern.Among them,the most outstanding type is the misjudgment of deficiency–cold pattern as excess–heat pattern.Conclusions:(1)Accurate judgment of location and differentiation of deficiency and excess patterns are the key points in diagnosing the diseases correctly.The confusion of true deficiency–cold and pseudo‑excess–heat pattern should be taken seriously.(2)Data mining on ancient clinical cases offers a new methodology for assisting clinical diagnosis of traditional Chinese medicine.展开更多
基金This study was financed by the grant from 2022 Liaoning Social Sciences Research Funds(No.L22CWW002).
文摘When narrative medicine(NM)was introduced into China,traditional Chinese medicine scholars found that the core concepts advocated by NM are manifested in Chinese yi’an.But why NM echoes with ancient Chinese yi’an?How can we better integrate NM into Chinese medical practices?To answer those questions,this article first investigates how NM establishes itself as a remedy to biomedicine by taking traditional healing models including TCM as its ideal Other.Then,the narrative traditions of both case histories and yi’an are examined respectively.This article argues that NM is searching for a lost tradition of narrative case histories,but yi’an functions as a living tradition of TCM.The Parallel Chart in NM,designed as a complement to the dehumanized hospital chart,is still based on a dichotomy of science and art and a conflictual doctor-patient model.But yi’an exemplifies the holistic and humane healthcare that NM hopes to achieve.A comparison of both genres also inspired us to rethink the genre of yi’an in NM.Thus,it is concluded that yi’an should be viewed as an epistemic genre integrating individualization and generalization,a bridge linking medicine and literature.And narrative yi’an can well serve as a tool for NM in China.It is also proposed that a thick description of yi’an be encouraged to further promote a pluralistic NM in China.
文摘Acne vulgaris is a chronic inflammatory skin disease damaging face,and the incidence of acne vulgaris is increasing year by year in China.Acne falls into the category of pimple in traditional Chinese medicine,and there are many dialectical understandings of acne in modern traditional Chinese medicine.Dr.He Aijuan has a unique diagnosis and treatment thinking in treating acne vulgaris(liver stagnation and spleen deficiency type)with traditional Chinese medicine in her clinical work for many years.Her application of Danggui Shaoyao Powder combined with Sini Powder has a remarkable effect in the clinical treatment process,so a clinical medical case is selected for discussion.
基金Technological Innovation Funds of Science and Technology Enterprises in Jiangsu Province(BC2015022)Horizontal Project of Nanjing University of Traditional Chinese Medicine(2019005)+1 种基金Six Talent Peak Projects in Jiangsu Province(RJFW-040)Jiangsu Province"333 High Level Talent Training Project"(2018)III-0121.
文摘Objective:Dysmenorrhea is a common gynecological disease.Some severe symptoms affect the quality of life,causing physical and psychological discomfort.To analyze the dysmenorrhea cases of famous Senior traditional Chinese medicine(TCM)doctors and TCM masters through the data mining technology and explore core related rules between the symptoms,pathogenesis,coated tongue,pulse condition,so as to deeply deconstruct the law of TCM clinical differentiation and treatment of dysmenorrhea,verify the effectiveness of the law,and optimize the clinical TCM diagnosis and treatment scheme.Methods:The external correlation analysis of dysmenorrhea medical cases through the Medcase data processing platform and the algorithm of FP-Growth enhanced association analysis was applied.Results:Altogether 171 medical records were studied,which included 171 female patients and 483 clinical visits.The age of the oldest patient was 49,the age of the youngest was 14,the average age was 28 years old.The medical cases involoved 41 kinds of pathogenesis,147 clinical symptoms,16 types of pulse condition,84 types of coated tongue and 292 traditional Chinese medicine.The external correlation processing revealed that there were 25 groups of clinical symptoms and TCM association rules;17 groups of clinical symptoms and secondary TCM association rules;21 groups of pathogenesis and Chinese medicine association rules;34 rules of coated tongue and Chinese medicine association rules;19 rules of pulse condition and Chinese medicine association rules;28 rules of clinical symptoms and pathogenesis associations.Conclusion:When treating dysmenorrhea according to the differentiation and treatment of TCM,the viscera location of the core pathogenesis mainly are kidney,spleen and liver,the pathological factors focus on blood deficiency,blood stasis and qi stagnation.The highly-related TCM include Danggui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),Chuanxiong(Rhizoma Ligustici),Yanhusuo(Rhizoma Corydalis),Xiangfu(Rhizoma Cyperi).The study of these rules has reference value for the acquisition of the core pathogenesis,the clinical differentiation and the medication.
基金supported by National Key Basic Research and Development Program "The research of literature review and comprehensive analysis on the theory of lung and large intestine are exterior-interior related"(No.2009CB522701)
文摘Objective: To analyze the similarities and differences of the applications of "the lung and large intestine being interior-exteriorly related"between the ancient and modern clinical practices, and to reveal the theory meaning.Method: Based on the ancient and modern medical cases database, 245 ancient medical records and 373 modern medical records were studied with the general statistical description and analysis of association rules, and the results were compared to summarize the similarities and differences of the regular pattern of syndrome and treatment on lung-large intestine related diseases in ancient and modern medical records.Results: In modern medical cases, intestinal diseases appeared with the main symptom of constipation due to deficiency of lung qi and qi stagnation of large intestine were always treated by purgation together with replenishing and restoring lung qi. In ancient medical cases, large intestine heat was always caused by lung heat and a variety of diarrhea symptoms appeared. They were always treated by clearing heat and moistening lungs. In addition, the symptom of bound stool caused by qi stagnation of large intestine due to lung qi stagnation was always treated by lowering lung qi to regulate and smooth large intestine qi. And Armeniae Amarum Semen was used by both as a core medicinal herb.Conclusion: Ascending-descending of qi movement is the core of the lung and large intestine relationship. In other words, the lung and the large intestine communicate through qi.
基金Budget Foundation of Shanghai University of TCM(A1-GY010130)Philosophy and Social Science Foundation of Shanghai(2019BTQ005)。
文摘Objective:To analyze misdiagnosis features in clinical cases of“Classified Medical Cases of Famous Physicians”and“Supplement to Classified Case Records of Celebrated Physicians.”Materials and Methods:Two hundred and five ancient misdiagnosed cases were analyzed in aspects of locations(exterior-interior type,qi-blood type and Zang‑Fu organs type)and patterns(heat-cold type and deficiency-excess type)by Apriori Algorithm Method.Results:The main types of misdiagnosis in those medical casesare as follows::Zang‑Fu location misjudgment,misjudging the interior as the exterior,misjudging deficiency pattern as excess pattern,and misjudging cold pattern as heat pattern.Among them,the most outstanding type is the misjudgment of deficiency–cold pattern as excess–heat pattern.Conclusions:(1)Accurate judgment of location and differentiation of deficiency and excess patterns are the key points in diagnosing the diseases correctly.The confusion of true deficiency–cold and pseudo‑excess–heat pattern should be taken seriously.(2)Data mining on ancient clinical cases offers a new methodology for assisting clinical diagnosis of traditional Chinese medicine.
