Students

Name: David Chen Qian

Post: Full-time M.Phil

Origin: Mainland China, Beijing 301 Hospital

Enrolled: 2001 - 2003

Title of Thesis:

The use of Traditional Chinese medicine in Hong Kong Chinese patients: A questionnaire survey

Outline of the Thesis:

Traditional Chinese medicine (TCM) has been used for thousands of years and is being used more widely on a worldwide basis. However, the use of TCM and the side effects are not well documented in Hong Kong.

A questionnaire survey was performed in the Prince of Wales Hospital to determine the conditions of patients who were taking TCM and the conditions of TCM use, and to try to determine if there were adverse effects from TCM or potential interactions with the orthodox drugs. In the survey 1,014 patients were interviewed and 683 patients returned the questionnaire.

At least one quarter of the patients liked to use TCM for treating diseases. More than one third of patients thought TCM were safer than the western medicine (WM). Seventy percent of patients agreed that it would be better in managing diseases if TCM and WM were integrated. Four fifths of patients thought TCM was more effective in disease prevention and health promotion than wM. Half the patients thought TCM were more effective in treating minor ailments than WM, but not in treating serious diseases.

Eighty percent of the patients took at least one particular herb boiled in soup in the Cantonese style for health promotion, even during their hospitalisation. There were 18 medicinal herbs commonly used in Cantonese soup with a report frequency over 20%, including Chinese yam, Barbary wolfberry fruit, Longan pulp and Ginger.

Of the patients who seek conventional medical services in the hospital, approximately 45% had seen TCM doctors at some time and 50% were prescribed Chinese herbal medicines to treat ailments and diseases such as common cold, headache, back pain, diabetes mellitus, hypertension, abnormal menstruation. cervical caner and bladder caner. More than 80% of the patients, who used the prescribed herbal medicines, felt their conditions improved, and of those 28% felt substantially improved. Most of the patients took the prescribed herbal medicines at least two times a week for at least one month. Patients reported that the efficacy of the prescribed TCM was enhanced with increased duration of the TCM use (p<0.05). Suspected adverse reactions including nose bleeding, dizziness, diarrhoea, stomach discomfort and sleepiness were reported in a low percentage of subjects.

Patients often seek TCM as an alternative or complementary modality, and perceive TCM as a safe and effective medication with minor adverse effects. However, medical professionals and the general public should pay more attention to the potential toxicity of herbal remedies, especially when patients are admitted to hospitals. It is desirable to develop a strict surveillance system on monitoring the safety issues of Chinese herbal medicines or Chinese proprietary medicines. It is recommended that the patient's use of TCM should be recorded in detail in the patient's medical notes with a routine clinical inquiry to the patient. Further investigations are needed to examine the efficacy of TCM and to pinpoint any drug interactions between TCM and orthodox drugs, with improvements of the survey's limitations.

Publications arising from his thesis:

(A) Scientific Papers:

1. Critchley LAH, Chen DQ, Chu TT, Fok BSP, Yeung C. Pre-operative hepatitis in a woman with cervical cancer treated with Chinese medicines. Anaesthesia 2003; 58:1096-1100.
   
   
2. Critchley LAH, Chen DQ, Lee A, Thomas GN, Tomlinson B. A survey of Chinese herbal medicine intake amongst preoperative patients in Hong Kong. Anaesthesia and Intensive Care 2005; 33: 506-513.
   

(B) Conference Abstracts:

3. 2002. ASA, ASM Adelaide. Anaesthesia & Intensive Care 2003; 31:113-114. Critchley LAH, Chen Q, Fok BSP, Chu T, Tomlinsom B. Chinese medicine usage by surgical patients in Hong Kong.
   
   
4. 2003. 11^th ASC HKCC, Hong Kong. Journal of the Hong Kong College of Cardiology 2003; 11: 136. Chen Q, Zhao HL, Fang YJ, Thomas GN, Chan JC, Critchley LAH, Tomlinson B. Use of Traditional Chinese Medicine in Patients with Hypertension and Hyperlipidaemia.
   
   
5. 2003. 11^th ASC HKCC, Hong Kong. Journal of the Hong Kong College of Cardiology 2003; 11: 136. Chen Q, Zhao HL, Hao A, Critchley LAH, Tong PC, Chan JC, Tomlinson B. Prescription of Chinese herbal medicine in Patients with essential hypertension.
   
   
6. 2003. 13^th International Symposium on Atherosclerosis, Kyoto, Japan. Atherosclerosis 2003;4(2): 337. Chen Q, Zhao HL, Thomas GN, Critchley LAH, Tomlinson B. Use of Chinese herbal medicine in hypertensive and dyslipidaemic patients: A questionnaire survey.
   
   
7. 2003. Satellite Symposium (13^th International Symposium on Atherosclerosis), Taipei, Taiwan. Chen Q, Thomas GN, Zhao HL, Fang YJ, Lester Critchley LAH, Tomlinson B. Use of Chinese Herbal Medicines in Patients with Dyslipidaemia: A Questionnaire Survey in Hong Kong.