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The Science Of Complementary Medicine
The latest trends
Four out of ten Americans were using alternative medicine and not telling their doctors(1). Chinese herbal medicine has helped people with irritable bowel syndrome(2). A ketogenic diet reduced intractable seizures in children (3) But according to other research, Echinacea extracts did not prevent upper respiratory infections (4) and chiropractic manipulation did not improve episodic tension-type headaches. (5)
These researches may have had their drawbacks. But according to another article published in the British Journal of Medicine, there are double standards in judging traditional and alternative medicine.6 At a conference on integrated medicine in London, Dr. Iain Chalmers said, “critics of complementary medicine seemed to operate with a double standard”. . It is thought that 60% of orthodox treatments have not been scientifically proven. (6)
In 1999, a series of articles was published in the British Medical Journal (BMJ) under the title – ABC of Complementary Medicine. Catherine Zollman and Andrew Vickers are the authors of these articles. In an article in this series published in the September 11, 1999 BMJ, the authors defined Complementary Medicine as “…a group of therapeutic diagnostic disciplines that exist primarily outside the institutions where conventional health care is taught and delivered. Complementary medicine is a growing feature of health care practice, but there remains considerable confusion about what exactly it is and what position the disciplines included in this term should hold in relation to conventional medicine”. (7)
According to another article published in the BMJ of September 25, 1999, a UK study on the use of complementary medicine estimated that in 1993, 33% of the population had used some form of complementary medicine. 55-65% of those who consulted complementary physicians were female, a proportion similar to users of conventional health care. Other highlights of this survey were:
· The highest users were those aged 35-60.
· Children made up a relatively small proportion of complementary medicine users.
· Complementary medicine users tended to be in higher socioeconomic groups and had higher levels of education than conventional care users.
More people used complementary medicine in the south of England than in Wales, Scotland and the north of England. But the evidence suggested that this reflected access to the availability of complementary practitioners rather than any substantial regional differences in public attitude or interest.(8).
Regarding acupuncture, the authors write: – “There is good research evidence that acupuncture has greater effects than placebo. Randomized trials have found that real acupuncture is more effective in relieving pain than ‘cheat’ techniques such as inserting of needles away from true points.” “Studies showing that acupuncture can affect anesthetized animals provide further evidence that its effects may not be explained simply in psychological terms.” (9)
“The best-known evidence for an herbal product concerns St. John’s wort (Hypericum perforatum) for the treatment of mild to moderate depression. A systematic review of 23 randomized controlled trials found that the herb was significantly superior to placebo and therapeutically equivalent to, but with fewer side effects than, antidepressants such as amitriptyline.” “Eighty-seven adults and children refractory to conventional first- and second-line treatment were randomized in a crossover study comparing a preparation of approximately 10 Chinese herbs with a placebo consisting of herbs thought to be ineffective for eczema. Highly significant reductions in eczema scores were associated with active treatment but not with placebo. At long-term follow-up, more than half of adults (12/21) and over 75% of children (18/23) who continued had a reduction greater than 90% in eczema scores”. (10)
Studies on Homeopathy
Evidence of the efficacy of homeopathic medicines was published in the BMJ.
The paper was authored by Morag A Taylor and collaborators. He concluded that homeopathic dilutions differ from placebo. This study was conducted on fifty patients suffering from perennial allergic rhinitis. Results showed significant improvement in nasal airflow compared to the placebo group (11). An earlier paper authored by Andrew Vickers and Catherine Zollman in the BMJ cited an article in the Lancet in favor of homoeopathy. The authors of this Lancet article were quoted as saying: – “The results of our meta-analysis are inconsistent with the hypothesis that the clinical effects of homeopathy are due to placebo.” “Laboratory studies have reported the biological effects of homeopathic remedies on animals, plants and cells, some at ultramolecular dilutions.” (12)
The mind-body connection in modern medicine
On another note, there is much research published in modern medical journals that proves the mind-body connection. The role of emotional disturbance and the origin of heart disease is an accepted fact in modern medicine. In a recent research conducted by Dr. Ketterer and colleagues at the Henry Ford Health Sciences Center in Detroit recommended that “chest pain should be considered a marker of emotional distress.” “Reducing emotional distress can benefit the (healthcare) system as well as the patient by spontaneously reducing emergency room visits, diagnostic tests, and hospital admissions.” (13)
A study done at the Cancer Institute of New Jersey by Dr. Pandya and colleagues concluded that conventional mind-body therapy has been poorer with a valuable non-invasive way to manage coronary disease. The practice of yoga is valuable in coronary diseases by improving resistance to stress. (14)
People with diabetes are twice as likely as non-diabetics to suffer from depression, according to an analysis of 25 years of data authored by Dr. Patrick J. Lustman of Washington University School of Medicine in St. Louis. “Two out of every three cases of depression in diabetes go untreated by primary care physicians”.(15) He recommends that both conditions should be treated together.
In a study published in Digestive Diseases and Science by Dr. Svein Blomhoff from the National Hospital, Oslo, demonstrated that there is a clear connection between mind and body. Emotional responses have an impact on gut reactivity in patients with irritable bowel syndrome (IBS) and in normal controls.
“The close interaction between the mind, brain, and gut” indicates that “gut motility can be a dynamic indicator of stress level or emotional state.”(16)
Psychotherapy is helpful for patients with intractable dyspepsia. A study was conducted by Dr. Elspeth Gutherei of Manchester Royal Infirmary and published in Gastroenterology in 2000. (17) In the same issue, Dr. David H. Alpers of Washington University School of Medicine, St. Louis. Louis, Missouri, advised gastroenterologists to pay attention to diagnostic and therapeutic psychological tools and learn to apply them to patients with functional bowel disorders.
Results from several controlled trials of “distant healing” show that such forms are positively effective. A study by Dr. John A Astin and colleagues at Kernon Hospital Mansion, in Baltimore Maryland, completed this finding. 23 trials were studied, including five trials of prayer, 11 studies of non-contact therapeutic touch, and seven trials of mental healing and spiritual healing.(18)
There is ample evidence in modern medical literature to suggest that there is a link between physical illness and emotional and mental distress. Research evidence shows that there is learning involved in “observation”. Every “scientific” discovery begins with “observation”. Observation is then followed by “scientific research.”
Complementary therapies follow the same model of knowledge as modern medicine has followed. Practitioners can make themselves more aware of the scientific basis of medicine by reading and researching modern medicine. Complementary medicine will have to become more scientific sooner rather than later.
1. Journal of the American Medical Association (1998) 280:1549-640
2. Journal of the American Medical Association (1998) 280:1585-90
3. Archives of Neurology (1998)55: 1433-8
4. Archives of Family Medicine (1998) 7: 541-5
5. Journal of the American Medical Association (1998) 280:1576-9
6. British Medical Journal (1998) 316:1694
7. British Medical Journal (1999) 319:693-696
8. British Medical Journal (1999) 319: 836-838
9. British Medical Journal (1999) 319:973-976
10 British Medical Journal (1999) 319: 1050-1053
11. British Medical Journal (2000) 321: 471-476
12. British Medical Journal (1999) 319: 1115-1118
13. Journal of Behavioral Medicine (2000) 23:437-44
14. Comparative Therapy (1999) 25(5): 283-93
15. Diabetes Care (2001) 24: 1069-1078
16. Digestive Diseases and Sciences (2000) 45: 1153-1165
17. Gastroenterology (2000) 119: 661-669, 869-871
18. Annals of Internal Medicine (2000) 132: 903-910
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