| The concept of EBM (Evidence-based Medicine) was first introduced in1992by the famous Canadian clinical epidemiologists and was defined as "To determine the treatment with the best research evidence possible aquired in the manner of prudence, precision and advisability", which is a methodology which can be found, evaulate and use evidence to guide clinical decisions. The prescription dose is one of the key factors and has been discussed since ancient times. At present,the historical study of the development and changes of the prescription does has been made some progress and how were TCM (Traditional Chinese Medicine) prescripitons such as Gegen Qinlian decoction and Maxing Shigan decoction used and what prescription does was used in ancient times have become clear. However, how are they used in modern times?Compared to the prescription does in Treatise on Febrile Diseases, how does the prescription does change?This study has learnt methods from EBM and use it to collect modern clinical research about Cegen Qinlian and Maxing Shigan decoction as many as possible and analysis all data to make clear about how these two prescriptions use especially for the does part. Hope the result can help to improve and perfect the theory of TCM does.1Objective(1)To estabilsh two different databases by using Gegen Qinlian decoction or Maxing Shigan decoction as interventions in clinical observations and divide contents into five parts to analysis and conclude.(2)Take does effect part as an important part to analysis, including how TCM prescripitions use resently and does part including single herb, the amount of classical prescriptions and TCM prescriptions to analysis the common dosage range, the average dosage, the most frequently used dosage, and the distribution extent from the minimum to the maximum dosage and so on.(3)Evaluate and analysis the quality of clinical studies and propose how to improve to get high qulity research and provide reference for furture research.(4)Let the result compare with what dosage herbs use in pharmacopoeia and be clear about the herbs dosage in modern clinical research.(5)According to the result,try to discuss how to research does effect relationship by using method from EBM.2Included studiesClinical observation in Chinese or English use Gegen qinlian or Maxing Shigan decoction as interventions except cases in1949-2012.3Methods(1)Use "Maxing Shigan decoction" and "Gegen Qinlian decoction" as the search term to search literature in CNKI, CBM, VIP, WanFang Data, PubMed, Embase and search other literature which is not in the database metioned due to years and other reasons by hand.(2)Read title and abstract of all the studies and download what this study need. Read full text of all literature downloaded to exclude some of them which is not needed or repeated in different database. Then classify the literature into two groups according to different decoctions.(3)Use excel to set up scale and enter data by hand. When all data was entered, researchers who involve in this study were going to proofread all data.(4) Use basic statistical methods to process data including standard deviation, variance, dispersion, arithmetic mean and so on, obtain the common dosage range, the average dosage,the most frequently used dosage,and the distribution extent from the minimum to the maximum dosage. Most of them are descriptive statistical analysis.3ResultsBased on a modified version of the Jadad scale, there are only three studies>4points, one in Gegen Qinlian part and the other two in Maxing Shigan part and these three accounted for only0.53%of all studies. The rest of studies are all low quality.In does effect research part, there were11%of all studies which didn’t have composition of prescriptions and14%of all studies which didn’t have dosage of the herbs in prescriptions in Gegen Qinlian part. In Maxing Shigan part, there were5%of all studies which didn’t have composition of prescriptions and20%of all studies which didn’t have dosage of the herbs in prescriptions.In single herb research of Gegen Qinlian part, the dosage of children of Gegen is similar to Gegen dosage range in pharmacopoeia. However, the adult dosage exceed the dosage of the pharmacopoeia. Maximum dosage of Gegen for adults is about1/2of Gegen maximum dosage in Treatise on Febrile Diseases. The dosage of children of Huangqin is similar to Huangqin dosage range in pharmacopoeia. However, the adult dosage exceed the dosage of the pharmacopoeia. Maximum dosage of Huangqin for adul ts is about3/4of Huangqin maximum dosage in Treatise on Febrile Diseases. The common dosage range of children of Huanglian is in Huanglian dosage range of pharmacopoeia, but the maximum dosage exceed dosage range of pharmacopoeia. The adult dosage exceed the dosage of the pharmacopoeia. Maximum dosage of Huanglian for adults is about2/5of Huanglian maximum dosage in Treatise on Febrile Diseases. The dosage of both children and adults of Zhigancao is similar to Zhigancao dosage range in pharmacopoeia. However, the maximum dosage for adults exceed the dosage of the pharmacopoeia. Maximum dosage of Zhigancao for adults is about2/5of Zhigancao maximum dosage in Treatise on Febrile Diseases. In single herb research of Maxing Shigan part, the common dosage range of both children and adults of Mahuang is similar to Mahuang dosage range in pharmacopoeia. However, the maximum dosage for both of them exceed the dosage of the pharmacopoeia. Maximum dosage of Mahuang for adults is about2/5of Mahuang maximum dosage in Treatise on Febrile Diseases. The dosage of both children and adults of Shigao is in Shigao dosage range in pharmacopoeia.Maximum dosage of Shigao for adults is about1/8of Shigao maximum dosage in Treatise on Febrile Diseases. The common dosage range of children of Xingren is in Xingren dosage range of pharmacopoeia, but the maximum dosage exceed dosage range of pharmacopoeia. The adult dosage exceed the dosage of the pharmacopoeia. Maximum dosage of Xingren for adults is about2/5of Xingren maximum dosage in Treatise on Febrile Diseases. The dosage of both children and adults of Zhigancao is similar to Zhigancao dosage range in pharmacopoeia. However, the maximum dosage for adults exceed the dosage of the pharmacopoeia. Maximum dosage of Zhigancao for adults is about2/5of Zhigancao maximum dosage in Treatise on Febrile Diseases.In the amount of classical prescriptions part for Gegen Qinl ian decoct ion, the amount of dosage of classical prescription for children is in the dosage range of pharmacopoeia and the adult dosage is about2times of children amount. The maximum dosage of adult is about1/2of dosage in Treatise on Febrile Diseases. In the amount of classical prescriptions part for Maxing Shigan decoction, the amount of dosage of classical prescription for children is in the dosage range of pharmacopoeia and the adult dosage is about1.6times of children amount. The maximum dosage of adult is about1/2of dosage in Treatise on Febrile Diseases.In the amount of all herbs in prescriptions,according to the result, the amount dosage of all herbs is2-2.5times of the amount dosage of herbs in classical prescriptions which means the amount of adding herbs for classical prescriptions is equal to or more than the amount of all herbs in classical prescriptions.In the number of herbs part,no matter adults or children, the average of the number of herbs is2times of the number of herbs in classical prescriptions.In dosage ratio part, compare to the ration in Treatise on Febrile Diseases, there are variety of conditions existing.4ConclusionAccording to the results in this study, there are8conclusions.(1)The number of literature has increased significantly recently but the overall quality still needs to be improved.(2)Clinical studies need to be standardized.(3)Clinical studies need to have more characteristics of TCM.(4) The dosage of children in classical prescriptions is in dosage range in pharmacopoeia. The adult dosage exceed the dosage of the pharmacopoeia but significantly lower than the dosage in Treatise on Febrile Diseases.(5)The amount of dosage of classical prescriptions for children is in the dosage range of pharmacopoeia which is much lower than adults dosage.(6) The amount of adding herbs for classical prescriptions is equal to or more than the amount of all herbs in classical prescriptions.(7) The average of the number of herbs is2times of the number of herbs in classical prescriptions.(8)There’s no obvious pattern about dosage ratio in this study. |
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