Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease.
Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease.
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DOI：
10.3389/fpain.2023.1233293
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
疼痛是镰状细胞病(SCD)的一种常见的、令人衰弱的、且鲜为人知的并发症。SCD的临床疼痛治疗需求在很大程度上没有得到满足，依赖阿片类药物作为主要的治疗选择，这导致了生活质量(QOL)的下降。文献资料表明，针灸对SCD的疼痛治疗有一定疗效。然而，这些临床研究缺乏中医辨证论治的指导。目的：探讨SCD患者中医辨证分型的临床表现差异。52名SCD患者和28名年龄和性别匹配的健康对照(HCS)参加了一项正在进行的针灸试验。每个参与者都完成了一系列关于疼痛、身体功能、疲劳、睡眠、焦虑、抑郁和生活质量的问卷，并在基线时接受了基于寒冷和压力的定量感觉测试。研究登记前12个月的处方阿片类药物使用数据被用来计算平均每日吗啡毫克当量(MME)。采用单因素方差分析和Tukey后置检验分析三个中医证型之间的差异。两样本t检验用于比较SCD组和HC组。中医诊断标准将SCD患者分为三个证型之一：(A)相等；(B)虚实；(C)郁滞。停滞组的疼痛干扰、躯体功能障碍、肿瘤性疼痛、疲劳、焦虑、抑郁、MME消耗量高于平等组，睡眠质量和生活质量低于平等组。在HCS组和等量SCD组之间几乎没有观察到结果的差异。根据观察到的临床表现和患者报告的临床表现来区分虚证和瘀滞组。这些发现表明，SCD的中医诊断证候可以通过验证的客观结果和患者报告的结果来区分。由于每个SCD患者的疼痛和合并症的特征是独特的，针对特定的中医“证候”，可能会通过符合中医原则的基于证候的个性化治疗方案来促进治疗效果。这些发现为开发基于中医证候的针对SCD疼痛的量身定制的针灸干预措施奠定了基础。需要更大的样本来进一步完善和验证SCD的中医诊断标准。
Pain is a common, debilitating, and poorly understood complication of sickle cell disease (SCD). The need for clinical pain management of SCD is largely unmet and relies on opioids as the main therapeutic option, which leads to a decreased quality of life (QoL). According to the literature, acupuncture has shown certain therapeutic effects for pain management in SCD. However, these clinical studies lack the guidance of Traditional Chinese Medicine (TCM) Syndrome Differentiation principles for treatment. To characterize differences in clinical presentation amongst TCM diagnosed Syndromes in SCD patients. Fifty-two patients with SCD and 28 age- and sex-matched healthy controls (HCs) were enrolled in an ongoing trial of acupuncture. Each participant completed a series of questionnaires on pain, physical function, fatigue, sleep, anxiety, depression and QoL and underwent cold- and pressure-based quantitative sensory testing at baseline. Data on prescription opioid use over the 12 months prior to study enrollment was used to calculate mean daily morphine milligram equivalents (MME). Differences among the three TCM Syndromes were analyzed by one-way ANOVA followed by Tukey post hoc testing. Two-sample t-tests were used to compare SCD and HC groups. TCM diagnosis criteria classified SCD patients into one of three TCM Syndromes: (a) Equal; (b) Deficiency; and (c) Stagnation. The Stagnation group exhibited higher pain interference, physical dysfunction, nociplastic pain, fatigue, anxiety, depression, MME consumption and lower sleep quality and QoL compared to the Equal group. Few differences were observed between HCs and the Equal SCD group across outcomes. Deficiency and Stagnation groups were differentiated with observed- and patient-reported clinical manifestations. These findings suggest that TCM diagnosed Syndromes in SCD can be differentially characterized using validated objective and patient-reported outcomes. Because characteristics of pain and co-morbidities in each SCD patient are unique, targeting specific TCM “Syndromes” may facilitate treatment effectiveness with a Syndrome-based personalized treatment plan that conforms to TCM principles. These findings lay the foundation for the development of tailored acupuncture interventions based on TCM Syndromes for managing pain in SCD. Larger samples are required to further refine and validate TCM diagnostic criteria for SCD.
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影响因子：
33.7
作者：
Dowell, Deborah;Ragan, Kathleen R;Jones, Christopher M;Baldwin, Grant T;Chou, Roger
通讯作者：
Chou, Roger
影响因子：
3.3
作者：
Lin, Jin-Mann S;Brimmer, Dana J;Reeves, William C
通讯作者：
Reeves, William C
影响因子：
4
作者：
Campbell, Claudia M.;Moscou-Jackson, Gyasi;Haythornthwaite, Jennifer A.
通讯作者：
Haythornthwaite, Jennifer A.
DOI：
10.1177/09645284211017303
发表时间：
2021-12
期刊：
Acupuncture in medicine : journal of the British Medical Acupuncture Society
影响因子：
--
作者：
Li H;Patil CL;Molokie RE;Njoku F;Steffen AD;Doorenbos AZ;Schlaeger JM
通讯作者：
Schlaeger JM
影响因子：
3.9
作者：
Arentz S;Smith C;Redmond R;Abbott J;Armour M
通讯作者：
Armour M