Alternative and Complementary Medicine. Dr Monem Alshok 21\5\2016 3o / 3 / 2017

Transcription

1 Alternative and Complementary Medicine Dr Monem Alshok 21\5\2016 3o / 3 / 2017

2 CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine,and alternative medicine is used in place of conventional medicine.

3

4 25% of all pharmaceutical drugs are derived from herbs The emergence of CAM.: Prior to 1990 little was known about who was using CAM 1993 study showed that 1 in 3 Americans sought some form of alternative care 1997 another follow up study revealed that 47% of Americans were using some form of CAM

5 Who Uses CAM? 2004 survey results: More women than men Higher education levels Hospitalized in the past year Former smokers Back, neck, head, or joint pain suffers Gastrointestinal disorders or sleeping problems

6 CAM 1. 7 CAM:Herbs, Accupuncture, Chiropractice, Homeopathy, Diet & Nutrition, Body Mind,Massage 2. 70% not report its use 3. Main complaits headache, Pains,Anxiety, Backpain, Cancer

7 Manipulative and Body-Based Methods Chiropractic medicine Osteopathic medicine

8 Manipulative and Body-Based Methods:Based on the manipulation and/or movement of one or more parts of the body. Types: Massage therapy Chiropractic manipulation Reflexology Osteopathy Massage: include Pressure, kneading, stroking, vibration, and tapping to positively affect health

9 Chiropractic medicine Adjustments by Manual treatments to re-align the vertebra and restore function of spinal nerves. Chiropractor : Performs an exam and takes a history Tests: X-rays,Muscle testing,analyzes posture

10 CAM Domains( Whole Medical System ) 1.Biologically based practice 2. Mind Body Medicine 3. Energy Medicine 4. Manipulative and bodily- based practice

11 Biologically Based Therapies Using substances found in nature, such as herbs, foods, and vitamins. Herbalism, Nutritional Counseling and Folk Medicine Aromatherapy involves the use of essential oils (extracts or essences) from flowers, herbs, and trees to promote health and well-being.

12 WHO statatistics show up to 80% of heart disease can be prevented by a healthy diet and lifestyle.

13 CAM Modalities Now in Mainstream Medicine Codeine for pain Digitalis for heart failure Ipecac for poisoning Quinine for malaria Aspirin for fever

14 Herbs When a plants or products made from them, can have a powerful impact on our bodies and when plants are used for such effects rather than as food, they are called Herbs

15 Dietary Supplements: Definition Product intended to supplement the diet Contains one or more of the following: Vitamin Mineral Herb or other botanical (not tobacco) Amino acid Any other dietary substance ueseful for the body For oral intake as a concentrate, metabolite, extract, constituent, or combination

16 Challenges of Herbal Medicines & Adverse effects Safety is assumed, not proven e.g Cabbage causes goiter,some plants are poisonous ( Herb Tea ) Lack of product standardization Contamination with drugs, heavy metals Allergic reactions Inherent toxicity Interactions with drugs Replacing proven therapies

17 Useful Herbal Products Echinacea Saw Palmetto Ginkgo Milk Thistle Ginger Chamomile Fever Few St. John s Wort Hawthorn Soy Kava Black cohosh Green tea Cranberry Yohimbe Valerian Garlic immune stimulant BPH circulation disorders liver disorders nausea indigestion migraine mild/mod depression heart/circulation menopause symptoms anxiolytic menopause symptoms stimulant (antioxidant) UTI prevention erectile dysfunction Sleep Disorders Hyperlipidemia

18 Probiotics: definitions World Health Organization: live microorganisms which when administered in adequate amounts confer a health benefit on the host A bacterial strain that: Survives the stomach acid and bile Adheres to intestinal lining Grows and establishes temporary residence in the intestines Imparts health benefit R Fuller. Probiotics: The Scientific Basis. London: Chapman and Halls. 1992

19 Probiotics 1. Lactobacillus sp. reuteri casei ramnosus acidophilus 2. Streptococcus sp. 3. Bifidobacterium sp. infantis lactis longum breve bifidum 4. Sacharomyces boulardii (nonhuman)

20 Prebiotics: Sources, Side effects: Sources: breastmilk, barley, bran and whole grains, legumes, such as beans; vegetables such as leeks, onions, asparagus, greens such as chicory, spinach, fruits such as bananas, berries Doses: 1 2 grams daily (adults) Side effects: flatulence, diarrhea, allergies

21 Probiotics Colonization at birth Similar to maternal species Specific organisms vary by age in first year Become established by 1 year In children and adults, Successful treatment with probiotics leads to temporary colonization only

22 Probiotics: proposed mechanisms 1. Adherence and subsequent stimulation of gut immune system Up-regulation of mucin gene Enhance secretory IgA Maintain normal macrophage function 2. Competition for essential nutrients 3. Production of antimicrobial factors 4. Provide favorable environment for growth of other beneficial bacteria 5. Production of short-chain fatty acids with antiinflammatory properties

23 Case A 13 year old recently diagnosed with osteogenic sarcoma says she s having trouble sleeping. She doesn t want any more meds. Valerian ( Root of Nardin )

24 Herbs African plum Herbs BPH Fenugreek seed Sexual stimulant for female, increase milk and breast size Garlic & onion Pumkin oil Rocket oil IHD, lipids, platelets& protection against GIT cancers Antiworms & BPH Body tonics for men Action Aloe Vera oil Chamomile St. John Wort Topically for sunburn & psoriasis & orally as laxative Dyspepsia, tension, immunity Depression

25 Gripe Water Traditionally dill extract ± bicarbonate (Woodard s ), ± alcohol; Dill, fennel and caraway are spasmolytics Some include ginger, fennel (Baby s Bliss ), chamomile, cinnamon and other herbs (Wellements )

26 Ginger for Nausea Numerous RCTs suggest benefits of ginger in preventing and treating nausea

27 IBS - Peppermint Peppermint (Mentha piperita); primary ingredient, 29% - 48% menthol Uses: many digestive complaints, including colic, flatulence, diarrhea, dyspepsia, indigestion, nausea and vomiting Relaxes smooth muscle and slows GI transit

28 Licorice: Glycyrrhiza glabra Contains: glycyrrhizin, glycyrrhizic acid, polyphenols, and polysaccharides TCM ulcer remedy; newer HepC? Inhibits 11 beta-hydroxysteroid dehydrogenase + other enzymes involved in the metabolism of corticosteroids. increased cortisol levels Anti-inflammatory and mineralocorticoid effects (BP, edema)

29 Bromelain An enzyme derived from the stem of pinapple plant ( Ananos Comosus) may help reduce swelling & inflammation

30 Cranberries juice Used to acidify urine and seems to make a more difficult for bacteria to stick to bladder wall

31 Herbs used to immune system Black seed Echinacea

32 Herbs Anise, Yansoon Sage, Thyme Z, Rosemary Ginger Chamomille

33 It s All Connected Principles

34 Physical Activity 1/3 of adult women are obese and 60% of women have no regular physical activity. Most studies suggest that active women have a 50% risk reduc/on in developing heart disease. Improves mood. May reduce risk of colon and breast by improving energy metabolism and reducing concentrations of insulin and related growth factors

35 Mind Heart Connection Review of 37 studies found patients who received mind body therapies and stress management had: 34% reduction in cardiac mortality 29% reduction in recurrence of heart attack Significant positive effects on cholesterol, blood pressure and weight.

36 Mind Body Medicine Belief that emotional, mental,social, spiritual, and behavioral factors affect health Respects and encourages individual s capacity for self knowledge and self care Yoga or tai chi Relaxation therapies Cognitive behavioral therapies Group support Meditation Creative arts therapy

37 Mind Body Medicine Review by Astin, et al. Concluded that there is considerable evidence that MBT are beneficial for: Coronary artery disease Headaches Insomnia Chronic low back pain Treatment related symptoms of cancer

38 Traditional Chinese Medicine Health is achieved by maintaining the body in a "balanced state. Imbalance leads to blockage in the flow of qi. TCM practioners typically use herbs, acupuncture, and massage to help unblock qi in an attempt to bring the body back into harmony and wellness TCM involves : Proper balance of Qi ( chi ) Acupuncture, herbal medicine, massage, qi gong

39 There are three main therapeutic modalities: 1. 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 herba 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) 2. Chinese Materia Medica is a standard reference book of information on medicinal substances that are used in Chinese herbal medicine. 3. Massage and manipulation

40 Whole Medical Systems Whole medical systems involve complete systems of theory and practice that have evolved independently from or parallel to conventional medicine. Many are traditional systems of medicine that are practiced by individual cultures throughout the world e.g. TCM

41 Acupuncture Significantly relieves pain Significantly improves function Effective complement to standard care The use of Hair Thin needles

42 ( Science of life ( Ayurveda A comprehensive system of medicine developed in India that places equal emphasis on the body, mind, and spirit, and strives to restore innate harmony of the individual. Primary treatments include diet, exercise, meditation, herbs, massage, and controlled breathing.

43 Homeopathy Like cures like Herbal medicine, minerals, and chemicals in diluted forms

44 Alternative Medical Systems: Complete systems of medical theory and practice. e.g. Homeopathic Medicine -In homeopathic medicine, there is a belief that "like cures like," meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms.

45 Naturopathy Restore health rather than cure disease Diet, clinical nutrition, homeopathy, acupuncture, herbal medicine, hydrotherapy, manipulation, light therapy, therapeutic counseling, pharmacology

46 Energy medicine Energy medicine Biofields Qigong Reiki Therapeutic touch

47 In CAM medicine one is not a Common healing foods A. Yogurt B. Cinamon C. Chamomale D. Oat fiber E. Anise

48 Which of the following is NOT a major domain of CAM practice? A. Bariatric surgery B. Manipulative and body-based practices C. Mind Body medicine D. Biologicall based Medicine

49 Naturopathy refers to: A. Alternative medical system originated in India B. The principles of " likes cure likes " C. Traditional Chinese Medicine D. creating a process that promotes the body's ability to heal itself

50 Chiropractic treatment often involves: A. Energy Therapy B. Herbs C. Analgesic D. Spinal Manipulation

51 Naturopathic Medicine: Proposes that there is a healing power in the body that establishes, maintains, and restores health. Practitioners work with the patient with a goal of supporting this power, through treatments such as nutrition and lifestyle counseling, dietary supplements, medicinal plants, and exercise

52 There are six principles that form the basis of naturopathic practice: The healing power of nature Identification and treatment of the cause of disease The concept of "first do no harm" The doctor as teacher Treatment of the whole person Prevention

53 Meditation Quieting the mind by focusing the attention. Benefits include: stress relief, relaxation, reduced level of lactic acid, efficient & effective oxygen consumption, slowed heart rate, decreased blood pressure, improved functioning of the immune system.