Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease
BackgroundPain 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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Pain Research |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2023.1233293/full |
| _version_ | 1797365532380364800 |
|---|---|
| author | Ying Wang Ying Wang David D. Wang Andrew Q. Pucka Andrew R. W. O’Brien Andrew R. W. O’Brien Steven E. Harte Richard E. Harris Richard E. Harris |
| author_facet | Ying Wang Ying Wang David D. Wang Andrew Q. Pucka Andrew R. W. O’Brien Andrew R. W. O’Brien Steven E. Harte Richard E. Harris Richard E. Harris |
| author_sort | Ying Wang |
| collection | DOAJ |
| description | BackgroundPain 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.AimTo characterize differences in clinical presentation amongst TCM diagnosed Syndromes in SCD patients.MethodFifty-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.ResultsTCM 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.ConclusionThese 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. |
| first_indexed | 2024-03-08T16:50:19Z |
| format | Article |
| id | doaj.art-b6317e648aac40ae8315105b7f16a6e4 |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-03-08T16:50:19Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-b6317e648aac40ae8315105b7f16a6e42024-01-05T04:49:35ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2024-01-01410.3389/fpain.2023.12332931233293Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell diseaseYing Wang0Ying Wang1David D. Wang2Andrew Q. Pucka3Andrew R. W. O’Brien4Andrew R. W. O’Brien5Steven E. Harte6Richard E. Harris7Richard E. Harris8Department of Anesthesia, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United StatesDivision of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United StatesCenter for Integrative Health, The Ohio State University, Columbus, OH, United StatesDepartment of Anesthesia, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United StatesDivision of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United StatesIndiana University Simon Cancer Center, Indianapolis, IN, United StatesDepartment of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, United StatesDepartment of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, United StatesDepartment of Anesthesiology and Perioperative Care, School of Medicine, Susan Samueli Integrative Health Institute, University of California, Irvine, Irvine, CA, United StatesBackgroundPain 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.AimTo characterize differences in clinical presentation amongst TCM diagnosed Syndromes in SCD patients.MethodFifty-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.ResultsTCM 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.ConclusionThese 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.https://www.frontiersin.org/articles/10.3389/fpain.2023.1233293/fullsickle cell diseasepaintraditional Chinese medicinesyndrome differentiationacupuncturepatient-reported outcomes |
| spellingShingle | Ying Wang Ying Wang David D. Wang Andrew Q. Pucka Andrew R. W. O’Brien Andrew R. W. O’Brien Steven E. Harte Richard E. Harris Richard E. Harris Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease Frontiers in Pain Research sickle cell disease pain traditional Chinese medicine syndrome differentiation acupuncture patient-reported outcomes |
| title | Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease |
| title_full | Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease |
| title_fullStr | Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease |
| title_full_unstemmed | Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease |
| title_short | Differential clinical characteristics across traditional Chinese medicine (TCM) Syndromes in patients with sickle cell disease |
| title_sort | differential clinical characteristics across traditional chinese medicine tcm syndromes in patients with sickle cell disease |
| topic | sickle cell disease pain traditional Chinese medicine syndrome differentiation acupuncture patient-reported outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2023.1233293/full |
| work_keys_str_mv | AT yingwang differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT yingwang differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT daviddwang differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT andrewqpucka differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT andrewrwobrien differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT andrewrwobrien differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT steveneharte differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT richardeharris differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease AT richardeharris differentialclinicalcharacteristicsacrosstraditionalchinesemedicinetcmsyndromesinpatientswithsicklecelldisease |