Adoption in China of Clinical Practice Guidelines for Hypertension Using Traditional Chinese Medical Approaches: A Literature Review Based on Clinical Studies

Shi, Nannan; Han, Xuejie; Yu, Wenya; Wang, Liying; Lü, Aiping

doi:10.1089/acm.2011.0776

Cited by 15 publications

(7 citation statements)

References 12 publications

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“…We also did not find significant changes for anger expression either between or within groups. Recent meta-analysis of psychological effects of the Transcendental Meditation technique have reported reductions in anxiety [ 69 , 70 ] and a long term trial in CHD patients found reduced anger expression over an average of five years follow up [ 65 ]. It may be that anger is a less sensitive marker of meditation over the short-term compared to long-term follow up.…”

Section: Discussionmentioning

confidence: 99%

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

et al. 2015

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BackgroundAfrican Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans.MethodsForty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes.ResultsBoth groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors.ConclusionIn this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP.Trial RegistrationClinicalTrials.gov NCT00681200

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Section: Discussionmentioning

confidence: 99%

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

et al. 2015

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“…In TCM, hypertension is classified by syndromes, including Gan-fire flaming-up syndrome, Yin-deficiency and Yang-excess syndrome, phlegm-dampness accumulation syndrome, and yin-yang deficiency syndrome [ 9 – 10 ]. Based on TCM principles various Chinese herbal therapies have been invented [ 10 – 11 ], and clinical guidelines have been developed[ 11 – 12 ]. For example Tian-Ma-Gou-Teng-Yin (Chinese herbal formula) is commonly used as an antihypertensive therapy.…”

Section: Introductionmentioning

confidence: 99%

Chinese Herbal Therapy and Western Drug Use, Belief and Adherence for Hypertension Management in the Rural Areas of Heilongjiang Province, China

Peng

et al. 2015

PLoS ONE

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BackgroundTraditional Chinese medicine (TCM) including Chinese herbal therapy has been widely practiced in China. However, little is known about Chinese herbal therapy use for hypertension management, which is one of the most prevalent chronic conditions in China. Thus we described Chinese herbal therapy and western drug users, beliefs, hypertension knowledge, and Chinese herbal and western drug adherence and determinants of Chinese herbal therapy use among patients with hypertension in rural areas of Heilongjiang Province, China.Methodology and Principal FindingsThis face-to-face cross sectional survey included 665 hypertensive respondents aged 30 years or older in rural areas of Heilongjiang Province, China. Of 665 respondents, 39.7% were male, 27.4% were aged 65 years or older. At the survey, 14.0% reported using Chinese herbal therapy and 71.3% reported using western drug for hypertension management. A majority of patients had low level of treatment adherence (80.6% for the Chinese herbal therapy users and 81.2% for the western drug users). When respondents felt that their blood pressure was under control, 72.0% of the Chinese herbal therapy users and 69.2% of the western drug users sometimes stopped taking their medicine. Hypertensive patients with high education level or better quality of life are more likely use Chinese herbal therapy.Conclusions and SignificanceMajority of patients diagnosed with hypertension use western drugs to control blood pressure. Chinese herbal therapy use was associated with education level and quality of life.

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“…Most criticisms of RCTs that ignore Kampo diagnosis come from individuals who have poor understanding of modern evaluation methodology. The use of traditional diagnosis in RCTs or CPGs has been discussed [20], [21]. The present study, however, does not discuss the superiority of Kampo-diagnosis use over its non-use.…”

Section: Discussionmentioning

confidence: 79%

Use of Kampo Diagnosis in Randomized Controlled Trials of Kampo Products in Japan: A Systematic Review

2014

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BackgroundThe Committee for Evidence-based Medicine (EBM) of the Japan Society for Oriental Medicine started compiling Evidence Reports of Kampo Treatment (EKAT) in 2007. EKAT is a compilation of structured abstracts of randomized controlled trials (RCTs), along with comments by a third party reviewer. As of 31 December, 2012, there were 378 RCTs of Kampo medicines in Japan. The primary research question of this study is “How frequently is Kampo diagnosis used in RCTs of Kampo medicines?” The secondary research question is “When is Kampo diagnosis used in RCTs?”Materials and MethodsThe structured abstract (SA) of each RCT article was reviewed to examine how Kampo diagnosis was used in RCTs, especially how Kampo diagnosis was used in the randomization process.ResultsKampo diagnosis was used before randomization in 27 RCTs (7.1%), after randomization in 31 RCTs (8.2%), and not used in 320 RCTs (84.7%). Before randomization, Kampo diagnosis was used as a criterion for inclusion in 10 RCTs, criterion for exclusion in 9 RCTs, and criteria for both inclusion and exclusion in 2 RCTs. Kampo formulas were determined according to Kampo diagnosis in 7 RCTs. After randomization, subgroup analyses according to Kampo diagnosis were done in 27 RCTs, and grade of disease severity at Kampo diagnosis was used for analysis as an endpoint in 4 RCTs.ConclusionsKampo diagnosis was used before randomization only in approximately 15% of RCTs, and the number of RCT articles using Kampo diagnosis after randomization was almost the same as that before randomization. Further studies to determine the good RCTs conforming to CONSORT requirements and good systematic reviews conforming to PRISMA requirements are needed to clarify the significance of Kampo diagnosis.

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Adoption in China of Clinical Practice Guidelines for Hypertension Using Traditional Chinese Medical Approaches: A Literature Review Based on Clinical Studies

Abstract: About 60% publications cited the CPGs for their clinical research, and most of them cited in an inconsistent and unclear way. According to the result, better training of TCM practitioners and improvement of CPG development and adoption are needed.

Cited by 15 publications

References 12 publications

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

Chinese Herbal Therapy and Western Drug Use, Belief and Adherence for Hypertension Management in the Rural Areas of Heilongjiang Province, China

Use of Kampo Diagnosis in Randomized Controlled Trials of Kampo Products in Japan: A Systematic Review

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