Guest guest Posted November 24, 2003 Report Share Posted November 24, 2003 The other thing that comes to mind is that Western Tests are not always that conclusive or obvious when it comes to the " disease " . Hep C pathogenisis often shows little relation to the enzyme and viral amounts detectable. Treatment is successful only when the virus is undectable for a few months after completion and then there are usually other complications so that a whole new endocrine disease has been formed. Another example is that more and more I see " thyroid " condidtions as being vastly more complicated than the Western TSH levels would seem to indicate. So research Chinese or otherwise often runs into the unreliability of the marker we use for testing purposes. doug , Rory Kerr <rory.kerr@w...> wrote: > At 3:54 PM +0000 11/24/03, wainwrightchurchill wrote: > >In my own clinical experience, some people need larger doses, some > >less - it also depends on what one is treating. I can't see that > >finding suitable doses is much of a problem for an experienced > >practitioner. It's like how much needle stimulation to give in > >acupuncture - once one has enough experience, one will trust one's > >judgement. > > > >I would be very careful about waiting for research to 'answer' this > >sort of question - it's entirely possible that standardisation would > >be a mistake, for more than one of the reasons cited above. > -- > > Wainwright, > > You've raised the issue of what is researchable, and if we were to do > research, what sort of information would we be looking for. As you've > pointed out, dosing is a matter of judgement, and so would be almost > impossible to reduce to a set of fixed rules. Even in pharmaceutical > medicine this is not possible, and specialists are always finessing > dosage for individual patients. I think we can probably say that > there is a rather wide range of doses that will have at least some > effect in any given case, but to find the optimum dose for that > patient at any given time is always going to require judgement. More > experienced and well trained practitioners are more likely to get the > optimum result more often, but most practitioners are going to get > some result in most cases if they stay within a fairly broad range of > dosing, and their treatment strategy is appropriate. > > Another factor to consider is that in Chinese herbal medicine, > treatment strategies are often used to achieve a short term goal, > within the context of a case that might take a long time to treat and > involve many different formulas. I think this level of complexity > does not lend itself to research studies, rather to well documented > case studies. > > Rory > -- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 24, 2003 Report Share Posted November 24, 2003 Doug, > The other thing that comes to mind is that Western Tests are not always that > conclusive or obvious when it comes to the " disease " . A posting this last weekend suggested that most contemporary Chinese medical research is tied to Western medical and biological markers. I read 13 or so Chinese journals per month, and I rotate journals from year to year so that I get a more representative picture (since I can't afford to to them all). I would say that the average Chinese CT is NOT tied to a laboratory marker. Most are clinical audits whose outcomes are defined to improvement in real-life clinical signs and symptoms. The typical Chinese CT in a CM journal has a section defining outcomes criteria. Almost never is alab result the sole criteria. Wehn lab results are criteria, they are usually on top of clinical signs and symptoms. More and more, Chinese authors are citing published sources for the definitions of their criteria, such as the Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Sun (Criteria for Chinese Medical Disease & Pattern Diagnosis, Treatment, & Outcomes). Before we get into an argument about research and criteria, I think it important to rebutt a characterization of contemporary Chinese research that was posted on this list. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 24, 2003 Report Share Posted November 24, 2003 Another example is that more and more I see " thyroid " condidtions as being vastly more complicated than the Western TSH levels would seem to indicate. So research Chinese or otherwise often runs into the unreliability of the marker we use for testing purposes. doug >>>There is also more testing available besides simple TSH Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2003 Report Share Posted November 25, 2003 Thanks for clarifying this Bob. And when I mentioned " chinese (research) or otherwise " later in the same post, I meant research concerning and not research coming out of China. doug , " Bob Flaws " <pemachophel2001> wrote: > Doug, > > > The other thing that comes to mind is that Western Tests are not always that > > conclusive or obvious when it comes to the " disease " . > > A posting this last weekend suggested that most contemporary Chinese medical research is tied to Western medical and biological > markers. I read 13 or so Chinese journals per month, and I rotate journals from year to year so that I get a more representative > picture (since I can't afford to to them all). I would say that the average Chinese CT is NOT tied to a laboratory marker. Most > are clinical audits whose outcomes are defined to improvement in real-life clinical signs and symptoms. The typical Chinese CT in a > CM journal has a section defining outcomes criteria. Almost never is alab result the sole criteria. Wehn lab results are criteria, they > are usually on top of clinical signs and symptoms. More and more, Chinese authors are citing published sources for the definitions of > their criteria, such as the Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Sun (Criteria for Chinese Medical Disease & Pattern > Diagnosis, Treatment, & Outcomes). > > Before we get into an argument about research and criteria, I think it important to rebutt a characterization of contemporary Chinese > research that was posted on this list. > > Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2003 Report Share Posted November 25, 2003 Bob et al, Can anyone tell us more about 'Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Sun (Criteria for Chinese Medical Disease & Pattern Diagnosis, Treatment, & Outcomes)' Wainwright Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2003 Report Share Posted November 25, 2003 I would be interested to hear your thoughts on the " vastly more complicated " aspects of thyroid conditions... especially on the shen level, as mind aspects of this are becoming more recognized in WM too. Do you treat spirit issues with herbs in your treatments for thyroid conditions? Pat The other thing that comes to mind is that Western Tests are not always that conclusive or obvious when it comes to the " disease " . Hep C pathogenisis often shows little relation to the enzyme and viral amounts detectable. Treatment is successful only when the virus is undectable for a few months after completion and then there are usually other complications so that a whole new endocrine disease has been formed. Another example is that more and more I see " thyroid " condidtions as being vastly more complicated than the Western TSH levels would seem to indicate. So research Chinese or otherwise often runs into the unreliability of the marker we use for testing purposes. doug , Rory Kerr <rory.kerr@w...> wrote: > At 3:54 PM +0000 11/24/03, wainwrightchurchill wrote: > >In my own clinical experience, some people need larger doses, some > >less - it also depends on what one is treating. I can't see that > >finding suitable doses is much of a problem for an experienced > >practitioner. It's like how much needle stimulation to give in > >acupuncture - once one has enough experience, one will trust one's > >judgement. > > > >I would be very careful about waiting for research to 'answer' this > >sort of question - it's entirely possible that standardisation would > >be a mistake, for more than one of the reasons cited above. > -- > > Wainwright, > > You've raised the issue of what is researchable, and if we were to do > research, what sort of information would we be looking for. As you've > pointed out, dosing is a matter of judgement, and so would be almost > impossible to reduce to a set of fixed rules. Even in pharmaceutical > medicine this is not possible, and specialists are always finessing > dosage for individual patients. I think we can probably say that > there is a rather wide range of doses that will have at least some > effect in any given case, but to find the optimum dose for that > patient at any given time is always going to require judgement. More > experienced and well trained practitioners are more likely to get the > optimum result more often, but most practitioners are going to get > some result in most cases if they stay within a fairly broad range of > dosing, and their treatment strategy is appropriate. > > Another factor to consider is that in Chinese herbal medicine, > treatment strategies are often used to achieve a short term goal, > within the context of a case that might take a long time to treat and > involve many different formulas. I think this level of complexity > does not lend itself to research studies, rather to well documented > case studies. > > Rory > -- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2003 Report Share Posted November 25, 2003 , " wainwrightchurchill " <w.churchill_1-@t...> wrote: > Bob et al, > Can anyone tell us more about 'Zhong Yi Bing Zheng Zhen Duan Liao > Xiao Biao Sun (Criteria for Chinese Medical Disease & Pattern > Diagnosis, Treatment, & Outcomes)' Wainwright, This book was published several years ago in Beijing. It contains standard criteria for disease diagnosis, pattern discrimination, treatment principles, and treatment outcomes. I have never personally seen a copy of this book. So I don't know how many diseases it covers. However, it is increasingly used as the standard in Chinese RCTs for establishing inclusion criteria, disease and pattern diagnosis, and treatment outcomes. Instead of each researcher having to come up with their own criteria for each of these, researchers are free to simply reference this text. You've stimuated me to write a friend who is currently in the PRC to see if I can get a copy. Bob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2003 Report Share Posted November 25, 2003 I mentioned the thyroid because of the women I have seen being diagnosed with thyroid nodules (small) and diagnosed with having Hypo thyroid. They were thin young women, more Hyper in stature. They reacted very negatively, especially emotionally to their Western medications which makes me suspect of the diagnosis. But tell me about the Shen element. You must have brought this up because of some thoughts you've had or theories you've heard. doug , " Pat Ethridge " <pat.ethridge@c...> wrote: > I would be interested to hear your thoughts on the " vastly more > complicated " aspects of thyroid conditions... especially on the shen level, > as mind aspects of this are becoming more recognized in WM too. Do you > treat spirit issues with herbs in your treatments for thyroid conditions? > > Pat > Quote Link to comment Share on other sites More sharing options...
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