Harmonizing Traditional Chinese and Modern Western Medicine,

学术英语 医学UNIT4 TAXT A

Harmonizing Traditional Chinese and Modern Western Medicine: A Perspective from the US Ka Kit Hui

M.D. F.A.C.P. Professor Department of Medicine UCLA School of Medicine Director UCLA Center for East-West Medicine

The current interest in traditional and complementary medicine in the United States is attracting attention in many parts of the community - the health care industry governmental agencies media and the public.1 An increasing number of insurers and managed care organizations are providing benefits for traditional medicine a majority of U.S. medical schools now offer courses covering traditional medicine23 and as Eisenberg’s national studies have revealed more people are using complementary therapies.45 To facilitate research on the effectiveness of alternative therapies the National Center for Complementary and Alternative Medicine NCCAM received a budget of 50 million in 1999. Recognizing the need to encourage quality and quantity of scientific information on botanicals as well as develop a systematic evaluation of safety and efficacy of dietary supplements two research centers were also established this year to investigate the biological effects of botanicals.6

Many patients are using traditional and modern medical paradigms concurrently creating a need for the appropriate and smooth merger of the two medicines. The theories and techniques of traditional Chinese medicine TCM encompass most practices classified as complementary medicine in the United States and have become increasingly important in the health care system.7 Traditional Chinese medicine is affordable low tech safe and effective when used appropriately. Ongoing research around the world on acupuncture herbs massage89 and Tai-Chi1011 have shed light on some of the theories and practices of TCM. Evidence derived from vigorous research design12 as well as patient demand are fueling the merger of TCM with modern medicine at the clinical level while more academic researchers and institutions are becoming more interested in the potential of integrating these two healing traditions. Acupuncture

Based on evidence reviewed during the 1997 NIH Consensus Conference the NIH Consensus Development Panel conservatively recommended that acupuncture may be used as an adjunct treatment an alternative or part of a comprehensive management program for a number of conditions. The panel ascertained that acupuncture can be used to treat post-operative and chemotherapy induced nausea and vomiting as well as post-operative dental pain. It was also recommended as an adjunct treatment or an acceptable alternative for addiction stroke rehabilitation headache menstrual cramps tennis elbow fibromyalgia myofacial pain osteoarthritis low back pain carpal tunnel syndrome and asthma.13

Future clinical trials that test acupuncture within the framework of traditional Chinese medicine are likely to provide a more appropriate and clinically meaningful assessment of acupuncture efficacy than the current generation of clinical trials which use a diagnosis framed primarily in biomedical terms. The scientific rigor of current research must continue however the NIH approach towards data analysis is too strict and limits potentially useful indications. Unlike drugs acupuncture is more akin to surgery and physical therapy in terms of therapeutic modalities. Hence the evaluation of evidence for efficacy in acupuncture ought to be similar to these therapeutic interventions. For the time being evidence based on large case series should be considered in determining recommendations for clinical practice while evidence derived from more vigorous research designs are being carried out.

学术英语 医学UNIT4 TAXT A

In elucidating the mechanisms of acupuncture and exploring its role in a variety of situations innovative techniques such as fMRI functional magnetic resonance imaging14 PET positron emission tomography SPECT single photon emission computer tomography and MEG magnetoencephalography are beginning to be utilized. Studies on acupuncture in terms of its neuroanatomic and neurophysiological bases bioelectrical properties analgesia effects and its role in regulation in areas such as gastrointestinal immunological and cardiovascular functions are being carried out. More intense research with increased funding and scientific vigor in an out of the US will likely uncover additional areas where acupuncture may prove useful. This will further drive the adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness. With technological advancement innovative methods of acupuncture point stimulation will continue to be explored and perfected. Basic research on acupuncture will also help facilitate improved understanding of neuroscience and other aspects of human physiology and function.

Because of heightened patient demand and better understanding of the role of acupuncture in health care through research and clinical experience the biomedical establishment health insurance industries physicians and other health care providers are beginning to take an interest in acupuncture. In time those who do not embrace acupuncture will be at a disadvantage. As the efficacy and cost saving potential of acupuncture is more widely recognized there will be an even stronger push for more insurance companies medical groups and even Medicare to provide coverage of acupuncture treatment. We will witness acupuncture being utilized increasingly in outpatient settings hospitals rehabilitation units and hospices. An increasing number of physician acupuncturists as well as non-physician acupuncturists are working in different clinical settings. Some licensed acupuncturist specialists will work side by side with MDs in specialized areas.

In the new millennium the practice of acupuncture will be guided not onl …… 此处隐藏：8248字，全部文档内容请下载后查看。喜欢就下载吧 ……