Complementary /AlternativeTherapies in Family Physician Practice

PhD, MD Mira Florea

UMF Cluj-Napoca

SUMMARY OF THE COURSE

• Physicians' reactions to the patients‘ increasing interest in Complementary Therapies

• Integrative Medicine - An Ideal ? • Complementary therapies

classification• Indications, Non-Indications

Course Motivation

• Increased demand for complementary therapy to the public

• The need for communication and co-operation with the medical services of

conventional/scientific medicine

• Ideally -integrative medicine  • Purpose -the safety of patients

DEFINITIE• Medical and health care practices outside the realm of

conventional medicine, which are yet to be validated using scientific methods

Complementary: together with conventional practicesAlternative: in place of conventional practices

MC/A =Unconventional Medicine =Unorthodox =Natural Medicine -whole concepts + practices different from those of

Conventional Medeicine =Scientific=Academic=Orthodox=Technique Medicine= Modern

DEFINITION

MC / A - uses the notion of body energy which works by influencing and shaping the energy component, influencing disease symptomatology, not the disease etiology and pathogenesis

•  Effects of alternative practices are not proved, though there are patients who confirm benefits

• Contraindications are reduced and the risk of adverse effects or overdoses is reduced

• Convenţional/ Scientific Medicine- addresses the anatomical body, the etiological component, influences disease's pathogenesis and symptomatology

• The scientific allopathic remedies are proved, but not all symptoms can be affected in the long term, and the side effects sometimes limited duration of therapy

Growing interest of patients for Complementary Therapies

• The natural source of these remedies, their Non-Toxicity increase patients’ adherence

• They are focused on the Emotional and Spiritual component of “Well-being”

• Therapists offer availability, time, communication, touch

• Scientific Medicine suffers from lack of time and that important “T T T” for the patients

“ Time, Talk, Touch”

The prevalence of Complementary Therapies use

• 62% of adults >18 ani use CAM • More women than men• Higher educated !!!!• Pain- is the most frequent symptom • Top 10 in EUROPE

– 41% Homeopathy, – 35 % Fitotherapy, Gemotherapy– 20% Acupuncture– 18% Chiropractic– 15% Diet-based therapies– 11% Massage– 6% Yoga

The prevalence of Complementary Therapies use

• Top 10 in USA– 43% Prayed for self; 10% participate in Prayer group– 19% Fitotherapy, Gemotherapy– 12% Deep breathing exercises– 8% Meditation– 8% Chiropractic– 5% Yoga– 5% Massage– 4% Diet-based therapies– 4% Homeopathy,– 3% Acupuncture

Doctors' reactions to the increasing patients' interest for MC / A

• diverse, from excitement and interest to the criticism, even circumspection

• British Medical Association-BMA manifested in favour of promoting some complementary therapies

• In England 40% of contracts concluded in the primary care offers complementary medicine services

• Many Family Physicians follow complementary medicine courses with various motivations:

• -the need to cope with the demands and interests of patients

• -the wish to increase their therapeutic resources

Doctors' reactions to the increasing patients' interest for MC / A

• The desire to widen conventional medicine which sometimes they feel stressful and unsatisfactory

• Maintaining a balance between increasing technologization of Conventional Medicine and a more humane approach of Complementary Medicine

• Complementary medicine Practice appeals to personality traits of doctors, facilitates communication and provides therapeutic satisfaction even for difficult patients or depressed patients.

Doctors' reactions to the increasing patients' interest for MC / A

• The majority of practitioners of MC/A originating outside the conventional framework of healthcare, WITHOUT MEDICAL QUALIFICATION and acting through a network of parallel health care services

In the US and the EU there was growing interest for MC/A particularly in diseases with high rates of morbidity, mortality or for those for whom Conventional Medicine do not fulfilled their expectations

• It is also called Parallel Medicine intense associated with nutritional supplements

PRINCIPLES of MC / A 1. To exclude organic disease

that can benefit from Conventional /Allopathic therapy

2. In addition to an allopathic treatment, with the agreement of the expert/specialist

CLASSIFICATION OF COMPLEMENTARY THERAPIES

• Groupe 1. • Complementary Therapies

benefiting from their own professional organizations

• Homeopathy• Acupuncture; Electropuncture;

Moxaterapy• Chiropractice• Osteopathy

CLASSIFICATION OF COMPLEMENTARY THERAPIES

• Groupe 2. Herbalism

• Fitotyerapy; Gemotherapy• Hidrotherapiy; Kinetotherapy• Masotherapy• Reflexotherapy, Presopuncture, Talasotherapy• Yoga; Meditation• Aromatherapy • Cromotherapy - therapy by colors• Melotherapy

CLASSIFICATION OF COMPLEMENTARY THERAPIES

• Groupe 3. Complementary disciplines

• Ayurvedic Medicine (India)• Traditional Chinese Medicine• Oriental – Tibetan Medicine• Cristalotherapy• Sacrotherapy

HOMEOPATHY• Similarity principle \"similia similibus

curantur" was known from Hippocrates period

• Samuel Hahnemann (1755), the founder of Homeopathy.

• The similarity lies in the fact that any sick can be healed with small doses of the substance that causes in large doses to healthy person symptoms similar to those of the disease

►the totality of the symptoms and signs of disease present in a patient can be healed of a substance likely to produce similar symptoms in a healthy person.

HOMEOPATHY

• Indications:

• Acute diseases: Viral Infections, Urinary infections, Functional digestive diseases

• Chronic diseases: especially those with imunopathogenesis -bronchitis, asthma, arthritis

•  

ACUPUNCTURE

ACUPUNCTURE

• Stimulating the various meridians of the body to restore the energy balance

• Electro-acupuncture - is associated with skin electrical stimulation

• It is successful in the algo-therapy, particularly in rheumatic disorders, but also in obesity –

Hunger Center Control

• Moxa-therapy, moxibustia -intradermal application of a combustion plant, dermal irritation - algolisis

 

GEMOTHERAPY- modern fitotherapy

• Use of vegetable-fresh buds, sprouts, under the action of a mixture of Glycerin and alcohol

• Most frequent used: chestnut, birch, cedar, silver fir, Hawthorn, fig tree, lemon

• Their content in: citokinine, fitocrom, glibereline work like a genuine micro-tissue therapy

•  Bio-Stimulines plant achieved a drainage, flebotonic action, cerebral tonus, strengthen fractures

CHIROPRACTIC, OSTEOPATHY

CHIROPRACTIC• Vertebral manipulation

techniques/manevre + massage with the aim of restoring joint mobility and joint function

OSTEOPATHY• repeated pressure of trigger points of

joints, ligaments, tendons, bone insertions decreasing pain, tenderness, stiffness

NATURAL MEDICINE

• CLINICAL ECOLOGY

– Monodiet –ex.Hyper-Proteic– Fasting-diet,– Vegetarianism, – Veganism

 • SACROTHERAPY• Therapy in Prayer group