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http://www.fda.gov/cber/gdlns/altmed.pdf
E. What Are whole Medical Systems?
NCCAM describes whole medical systems as involving
complete systems of theory and practice that have evolved independently
from or parallel to allopathic (conventional) medicine.? These
may reflect individual cultural systems, such as traditional Chinese
medicine and Ayurvedic medicine. Some elements common to whole medical
systems are a belief that the body has the power to heal itself, and that
healing may involve techniques that use the mind, body, and spirit.
Whole medical systems involve complete systems of theory and practice
that have evolved independently from or parallel to allopathic
(conventional) medicine. Many are traditional systems of medicine that are
practiced by individual cultures throughout the world. Major Eastern whole
medical systems include Traditional Chinese Medicine--A
whole medical system that originated in China. It is based on the
concept that disease results from disruption in the flow of qi and
imbalance in the forces of yin and yang. Practices such as herbs,
meditation, massage, and acupuncture seek to aid healing by restoring the
yin-yang balance and the flow of qi. .....
Traditional Chinese Medicine
TCM is a complete system of healing that dates back to 200 B.C. in
written form. Korea, Japan, and Vietnam have all developed their own
unique versions of traditional medicine based on practices originating in
China. In the TCM view, the body is a delicate balance of two opposing and
inseparable forces: yin and yang
The concept of two opposing yet complementary forces described in
traditional Chinese medicine. Yin represents cold, slow, or passive
aspects of the person, while yang represents hot, excited, or active
aspects. A major theory is that health is achieved through balancing yin
and yang and disease is caused by an imbalance leading to a blockage in
the flow of qi.. Yin represents the cold, slow, or passive principle,
while yang represents the hot, excited, or active principle. Among the
major assumptions in TCM are that health is achieved by maintaining the
body in a "balanced state" and that disease is due to an internal
imbalance of yin and yang. This imbalance leads to blockage in the flow of
qi In traditional Chinese medicine,
the vital energy or life force proposed to regulate a person's spiritual,
emotional, mental, and physical health and to be influenced by the
opposing forces of yin and yang. (or vital energy) and of blood along
pathways known as meridians. TCM practitioners typically use herbs,
acupuncture A family of procedures
that originated in traditional Chinese medicine. Acupuncture is the
stimulation of specific points on the body by a variety of techniques,
including the insertion of thin metal needles though the skin. It is
intended to remove blockages in the flow of qi and restore and maintain
health., and massage Pressing,
rubbing, and moving muscles and other soft tissues of the body, primarily
by using the hands and fingers. The aim is to increase the flow of blood
and oxygen to the massaged area. to help unblock qi and blood in
patients in an attempt to bring the body back into harmony and wellness.
Treatments in TCM are typically tailored to the subtle patterns of
disharmony in each patient and are based on an individualized diagnosis.
The diagnostic tools differ from those of
conventional medicine Medicine as
practiced by holders of M.D. (medical doctor) or D.O. (doctor of
osteopathy) degrees and by their allied health professionals such as
physical therapists, psychologists, and registered nurses.. There are
three main therapeutic modalities:
- Acupuncture and moxibustionIn
traditional Chinese medicine, the use of heat from burning the herb moxa
on or near the skin at an acupuncture point. Intended to stimulate the
flow of qi and restore health. (moxibustion is the application of
heat from the burning of the herb
A plant or part of a plant used for its flavor, scent, or potential
therapeutic properties. Includes flowers, leaves, bark, fruit, seeds,
stems, and roots. moxa at the acupuncture point)
- Chinese Materia Medica (the catalogue of natural products used in
TCM)
- Massage and manipulation
Although TCM proposes that natural products catalogued in Chinese
Materia Medica or acupuncture can be used alone to treat virtually any
illness, quite often they are used together and sometimes in combination
with other modalities (e.g., massage, moxibustion, diet changes, or
exercise).
The scientific evidence on selected modalities from TCM is discussed
below.
Acupuncture
The report from a Consensus Development Conference on Acupuncture held at
the National Institutes of Health (NIH) in 1997 states that acupuncture is
being "widely" practiced--by thousands of acupuncturists, physicians,
dentists, and other practitioners--for relief or prevention of pain and
for various other health conditions.1
In terms of the evidence at that time, acupuncture was considered to have
potential clinical value for nausea/vomiting and dental pain, and limited
evidence suggested its potential in the treatment of other pain disorders,
paralysis and numbness, movement disorders, depression, insomnia,
breathlessness, and asthma.
Preclinical studies have documented acupuncture's effects, but they
have not been able to fully explain how acupuncture works within the
framework of the Western system of medicine.
It is proposed that acupuncture produces its effects by the conduction
of electromagnetic signals at a greater-than-normal rate, thus aiding the
activity of pain-killing biochemicals, such as endorphins and immune
system cells at specific sites in the body. In addition, studies have
shown that acupuncture may alter brain chemistry by changing the release
of neurotransmitters and neurohormones and affecting the parts of the
central nervous system related to sensation and involuntary body
functions, such as immune reactions and processes whereby a person's blood
pressure, blood flow, and body temperature are regulated.2,3
Chinese Materia Medica
Chinese Materia Medica is a standard reference book of information on
medicinal substances that are used in Chinese herbal medicine.4
Herbs or botanicals usually contain dozens of bioactive compounds. Many
factors--such as geographic location, harvest season, post-harvest
processing, and storage--could have a significant impact on the
concentration of bioactive compounds. In many cases, it is not clear which
of these compounds underlie an herb's medical use. Moreover, multiple
herbs are usually used in combinations called formulas in TCM, which makes
the standardization of herbal preparations very difficult. Further
complicating research on TCM herbs, herbal compositions and the quantity
of individual herbs in a classic formula are usually adjusted in TCM
practice according to individualized diagnoses.
In the past decades, major efforts have been made to study the effects
and effectiveness of single herbs and of combinations of herbs used in
classic TCM formulas. The following are examples of such work:
- Artemisia annua. Ancient Chinese physicians identified that
this herb controls fevers. In the 1970s, scientists extracted the
chemical artemisinin from Artemisia annua. Artemisinin is the
starting material for the semi-synthetic artemisinins that are proven to
treat malaria and are widely used.5
- Tripterygium wilfordii Hook F (Chinese Thunder God vine).
Thunder God vine has been used in TCM for the treatment of autoimmune
and inflammatory diseases. The first small randomized,
placebo-controlled trial of a Thunder God vine extract in the United
States showed a significant dose-dependent response in patients with
rheumatoid arthritis.6
In larger, uncontrolled studies, however, renal, cardiac, hematopoietic,
and reproductive toxicities of Thunder God vine extracts have been
observed.
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