1.Thinking and Practice of Clinical Evidence-based Evaluation in TCM with Disease-syndrome Diagnostic System
Tengwen LIU ; Yifan SHI ; Tianyuan WANG ; Qian LIU ; Zhishuo FAN ; Guozhen ZHAO ; Jing HU ; Dong WANG ; Bo LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):127-136
In recent years, there have been both achievements and criticisms in using the methods of evidence-based medicine to evaluate the efficacy of traditional Chinese medicine (TCM), which is mainly due to the differences between TCM and Western medicine. To facilitate the clinical evidence-based evaluation in TCM, this paper analyzes the challenges faced in TCM clinical evaluation, particularly in the diagnosis, clinical intervention, and efficacy assessment methods. Considering the current state of TCM clinical evaluation and our clinical research experience, we believe that establishing and refining the TCM disease-syndrome diagnostic system is a prerequisite for the practice of clinical evidence-based evaluation in TCM. Furthermore, this paper discusses the specific connotation, development, and challenges of the disease-syndrome diagnostic system, especially the choice of TCM disease name or modern medical disease name in this system. Then, the clinical application scenarios are expounded from ''TCM disease name + syndrome differentiation'' and ''Western medicine disease name + syndrome differentiation''. Moreover, this paper proposed solutions for practical issues such as the standardization of disease and syndrome diagnosis, selection of clinical evaluation methods, and application of evidence-based approaches in clinical evaluation. Establishing the criteria for the disease-syndrome diagnostic system is crucial for the determination of clinical intervention regimen, the selection of clinical research methods, and the establishment of evaluation indicators, which are essential for generating high-quality clinical evidence. To sum up, this paper reviews the development and current situation of the disease-syndrome diagnostic system and proposes an exploratory approach for the standardization and application of this system in clinical evidence-based evaluation. This approach aims to facilitate the integration of TCM with modern clinical practice, thereby achieving standardized evaluation of TCM efficacy and deepening the integration of TCM with evidence-based medicine.