美国白宫补充替代医学政策委员会最终报告评介

补充替代医学可以定义为除主流医学外的一组医疗保健形式。介绍了补充替代医学在美国的情况和白宫补充替代医学政策委员会最终报告概要。      

消费者重塑医院美国医院补充与替代医学的发展历程

补充和替代医学除了在民间被逐渐接受外,还以一种出人意料的方式登上了主流医学的“大雅之堂”近年来,作为主流医学(西医)的补充或替代治疗方法,补充与替代医学(complementary andalternative medicine,CAM)在美国获得了长足发展。C A M被定义为“主流医学之外,能补充主流医学的不足并提供主流医学不能达到的诊断、治疗和预防方法”。2002年美国国家健康询问调查资料显示,36%的成年人在近一年中曾经接受过一些C A M治疗。其他研究显示,近2/3的成人至少使用过一种C AM治疗,但是大多数人并没有把这段经历告诉他们的医生。调查了解到,患者…     

日本替代医学的现状

在日本,“替代医学·替代医疗”一词还是不多见的习惯用语,而在欧美等国,近年来替代医学是飞速发展的医学领域之一。1替代医学·医疗的定义日本替代医疗学会(2000年4月,改称为日本补充·替代医疗学会)将替代医学·医疗定义为“在现代西医学领域中未经科学验证的和临床尚未应用的医学·医疗体系的总称”。而在美国将其称之为alternativemedicine或Complementaryandalterna-tivemedicine(简称CAM)。最近又称之为integrativemedicine。在日本第1次替代医学学会上,认为替代医学·医疗是指“一般医学院校中没有编入正式课程的医学领域;一般医院…     

美国补充替代医学研究的主要机构(一)——关国癌症研究所和哈佛医学院

与对抗医学(allopathic medicine)的诊疗理念和实践有着重大区别的补充替代医学(complementary and alternative medicine,CAM)于20世纪70年代在美国达到第一个高峰,并且"替代医学"这个名词在此期间开始使用[1].此后,随着非常规医学在美国使用人数的迅速增多以及所治病种的不断增加,相关的基础研究和临床试验也相继展开,并且开始设立专门的CAM研究机构.     

替代医学在癌症患者中的应用现状与前景

1992年,为了支持和协调替代医学的研究,向大众传播有关替代医学的最新研究成果,美国设立了补充与替代医学办公室,这在美国替代医学史上有着里程碑的作用。1998年,该办公室经国会授权成为国家补充与替代医学中心     

译后评论：主流医学与补充医学整合的可能性和必然性

20世纪 70年代尼克松访华后 ,针灸疗法在美国及欧洲迅速得到推广应用。随后 ,整脊疗法 (ｃｈｉｒｏｐｒａｃｔｉｃｔｈｅｒａｐｙ)等也相继被推广应用 ,成为现代医学即主流医学 (ｍａｉｎｓｔｒｅａｍｍｅｄｉｃｉｎｅ)或称习用医学 (ｃｏｎｖｅｎｔｉｏｎａｌｍｅｄｉｃｉｎｅ)的补充治疗或替代治疗的方法。除针灸和整脊疗法外 ,补充医学(ｃｏｍｐｌｅｍｅｎｔａｒｙｍｅｄｉｃｉｎｅ ,简称ＣＡＭ)还包括按摩 (ｍａｓｓａｇｅ)、生物反馈 (ｂｉｏｆｅｅｄｂａｃｋ)、粗维生素 (ｍｅｇａｖｉｔａｍｉｎｅｓ)、顺势疗法(ｈｏｍｅｏｐａｔｈｙ…     

是否应该在非洲医学院校中教授补充替代医学？

在非洲社会,补充替代医学疗法是家庭常用的疗法。大多数非洲人使用补充替代医学疗法替代主流医学疗法。出现这一现象的原因一是因为传统,二是因为很多人从经济上无法负担常规的治疗手段。在发达国家,补充替代医学的使用不断增长,因此,这些国家的很多医学院校将补充替代医学的课程纳入了医学本科生的课程体系。而在非洲,大部分医学院校并没有向学生教授补充替代医学。基于越来越多的非洲人开始使用补充替代医学疗法,以及潜在的补充替代医学疗法与常规疗法的相互作用,医生们有必要熟知那些常用的补充替代医学疗法。要达到这一目标,建议将补充替代医学的课程纳入非洲医学院校医学本科生的授课体系。这将有助于未来的非洲医生掌握整体治疗的手段,并与国际的发展趋势接轨。     

美国补充替代医学研究的主要机构(一)——美国癌症研究所和哈佛医学院

与对抗医学（allopathic medicine）的诊疗理念和实践有着重大区别的补充替代医学（complementary and alternative medicine.CAM）于20世纪70年代在美国达到第一个高峰。并且“替代医学”这个名词在此期间开始使用。此后．随着非常规医学在美国使用人数的迅速增多以及所治病种的不断增加．相关的基础研究和临床试验也相继展开,并且开始设立专门的CAM研究机构。     

美国补充替代医学研究的主要机构（一）——美国癌症研究所和哈佛医学院

与对抗医学（allopathic medicine）的诊疗理念和实践有着重大区别的补充替代医学（complementary and alternative medicine.CAM）于20世纪70年代在美国达到第一个高峰。并且“替代医学”这个名词在此期间开始使用。此后．随着非常规医学在美国使用人数的迅速增多以及所治病种的不断增加．相关的基础研究和临床试验也相继展开，并且开始设立专门的CAM研究机构。     

马里兰大学医学院结合医学中心——美国医学院最早成立的替代医学中心

马里兰大学医学院的补充医学中心成立于1991年,是美国在西医学院成立的第一个以研究中医药为主的综合性补充和替代医学中心。从1995年起连续被美国国家健康研究院评为全国中医研究的杰出中心,研究主要集中在评估中医药、针灸和身心疗法如气功、冥想疗法的安全性、有效性及作用机制。补充医学中心作为马里兰大学的交叉学科中心,主要承担了科研、临床、文献和教育4个方面的工作,彼此促进,已形成一个充满凝聚力的团队。中心近年来还增加了针灸和中医药研究在国际间的交流合作,特别与中国的香港中文大学、上海中医药大学和其他中医药大学进行了合作。     

FDA acknowledges TCM belonging to whole medical systems

Recently, 2007, the U.S. Food and Drug Administration (FDA) issued a draft guidance for the industry, titled "Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug     

Cancer complementary and alternative medicine research at the US national cancer institute

The United States National Cancer Institute(NCI) supports complementary and alternative medicine(CAM) research which includes different methods and practices (such as nutrition therapies) and other medical systems(such as Chinese medicine). In recent years,NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention,treatment,symptom/side effect management and epidemiology.The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments,mind-body interventions,manipulative and body based methods,alternative medical systems,exercise therapies,spiritual therapies and energy therapies on a range of types of cancer.The NCI Office of Cancer Complementary and Alternative Medicine(OCCAM) supports various intramural and extramural cancer CAM research projects.Examples of these cancer CAM projects are presented and discussed.In addition,OCCAM also supports international research projects.     

Ginger: an ancient remedy and modern miracle drug

Ginger has been used safely for thousands of years in cooking, and medicinally in folk and home remedies. Advanced technology enables the validation of these traditional experiences. The National Center for Complementary and Alternative Medicine (NCCAM) has evaluated the results of the available studies, rating the reports from "suggestive" (for short-term use of Ginger for safe relief from pregnancy related nausea and vomiting), to "mixed" (when used for nausea caused by motion sickness, chemotherapy, or surgery), and to "unclear" for treating rheumatoid arthritis, osteoarthritis, or joint and muscle pain). NCCAM has funded investigators to study interactions of ginger with drugs (immunosuppressants), its effect of reducing nausea in patients receiving chemotherapy, and the safety and effectiveness of its use for health purposes, as well as its impact on inflammation. Upon completion of these studies, the scope of ginger's use will be clearly identified and incorporated into mainstream therapeutic options, thereby integrating east and west, old with new, to render ginger as a true "Universal Remedy".     

国外补充和替代医学的发展对我国中医药事业发展的借鉴

补充与替代医学逐步被欧美等现代医学高度发达的国家认可和接受,成为西方主流医学的重要补充体系。中医学是替代医学的主要组成部分。通过分析替代与补充医学的快速发展给我国中医药事业带来的机遇,结合我国中医药发展现状,提出有利于促进中医药事业发展的途径,为我国中医药的发展提供借鉴。     

Complementary and alternative medicine (CAM): a review for the primary care physician

It is difficult to find a satisfactory title for this review, because both the word "complementary" and "alternative"-are not very politically correct currently. It is probable that there is no fully politically correct word, except for "non-allopathic," which is unfamiliar to many MDs. Accurately used, the term "allopathic" is as opposed to "homeopathic," so from its origins, "allopathic medicine" should include herbal medicine. However, in practice, herbal and many other non-homeopathic treatments are called "non-allopathic," whereas conventional medicine is called "allopathic." "Complementary" usually would include practices that are used with conventional western medical treatments, and "alternative" would include those practices that are used instead of western medical treatments. For most of this review, the terms "non-allopathic," "alternative," and "complementary" could be used interchangeably. This topic has gained interest, and received some allopathic legitimacy, in part because of an article that David Eisenberg, M.D., published in the New England Journal.' In 1990, he performed a telephone survey of about 1,500 adults in the U.S. and asked them about the use of treatments and practices that were "alternative," which he defined as not generally being taught in the U.S. medical schools and not being readily available in U.S. hospitals. From his sample, he extrapolated that in 1990, about 60 million Americans used alternative medical treatments, at an estimated cost of $13.7 billion. There were more visits to alternative healers than to primary care MDs that year, and over two-thirds of people who did use alternative medical treatments did not tell their doctors about it. Now that third party figures are becoming interested in paying for alternative medical practices (especially naturopathic, chiropractic, and acupuncture services), allopathic physicians will be increasing in the position of being able to refer people to alternative providers, and insurers will pay for services that MDs approve. Therefore, it will become increasingly important for physicians to have a degree of familiarity with alternative treatments (including efficacy and risks). So far, to date, there have been no cases of malpractice for giving advice about the use of alternative medical treatments, but liability will certainly exist to anyone who delivers treatments, such as acupuncture or spinal manipulation, in the event of an adverse effect. This review will briefly introduce some of the most common alternative practices likely to be seen in Hawaii communities: Homeopathy, Herbs, Naturopathy, Chinese Medicine and Acupuncture, and Chiropractic and spinal manipulation, and a brief discussion of Dr. Eisenberg's recent position paper on advising patients about alternative practices.     

美国补充替代医学的科研现状及其与中国中医药研究的比较

美国对包括中医药在内的补充替代医学的研究日益关注。研究规模与投入不断增加。中医疗法的偏重、东西方知识背景、思维方式以及对中医理论认可程度的不同导致中国和美国在中医学研究的内容和思路上存在差异。     

中医药国际化的必备条件与因素

随着全球政治、经济和文化等一体化趋势的不断深化,中医在全球这一共同体中遇到了前所未有的发展机遇,创造了一个又一个的显著成就,但是依然面临很多新老问题,例如外国人对中医、东方医学与针灸的片面认识,国外广泛存在的不规范的中医和针灸培训学校,不合格的中医师,中医师经营中医事业中的经验不足等。从长远角度考虑,这些问题的存在都将成为中医药实现全球化这个终极目标的阻碍,而中医全球化的目标又注定是一项规模宏大的系统工程和长期艰巨的历史任务,因而要求我们要有紧迫感和长期奋斗的准备。本文旨在通过对中医药在美国的发展现状和存在问题的详细分析,提出扩大和完善中医药全球化发展的6大战略发展计划。     

Health spending,illicit financial flows and tax incentives in Malawi

This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes

• Illicit financial flows (IFF) from the country
• Tax incentives.

We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400million is lost through IFF and corporate utilization of tax incentives each year.The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi''s disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.     

Role of traditional Chinese medicine in integrative medicine

Complementary & alternative medicine (CAM) is getting more and more important in improving human health. Traditional Chinese medicine (TCM), with her thousands of years history and contributions to the health of Chinese people, definitely is vital in CAM in China. Medical sciences including CAM and mainstream medicine, with unified specific aim, could be integrated and become integrative medicine. During the integration, TCM would contribute much more in the progress with her cultural background and clinical efficacy. This paper will discuss how TCM takes part in the inte gration via her function in clinical practice.     

基于WOS核心合集数据库探讨中医针灸调节瞬时受体电位通道的研究现状与展望

目的:梳理、探讨中医针灸调节瞬时受体电位(Transient Receptor Potential,TRP)通道的研究现状与发展趋势,并对未来中医针灸调节TRP通道研究进行展望与思考。方法:以《科学引文索引》(Science Citation Index,SCI)数据库网络版(Web of Science,WOS)核心合集数据库为数据源,从文献的国家/地区、文献类型、作者、资金资助机构、研究方向、来源出版物、影响因子、被引频次,以及文献内容中涉及的疾病类型、TRP亚型、穴位、检测方法、动物品系等方面,对WOS核心合集数据库收录中医针灸调节TRP通道研究的文献进行分析与探讨。结果:共检索到96篇文献,57篇纳入分析,主要文献类型是研究论文(article)。中国(包括台湾地区)发表论文数量最多,总IF、总被引频次最高,且发表论文数量最多的作者、资金资助机构均来自中国(包括台湾地区);《循证补充和替代医学》是刊载文献数量最多的期刊;综合补充医学是最主要的研究方向;疼痛是研究的主要疾病类型;TRPV1是最主要的TRP研究亚型;足三里穴、WB,分别是使用频率最高的穴位、检测方法。结论:中国是中医针灸调节TRP通道研究的主要科研力量;中医针灸调节TRP通道的研究主要聚焦于TRPV1与疼痛的研究;相关研究尚处于起步阶段,未来需进一步拓展、完善研究的设计思路与方法,提高研究成果的科技影响力。