TCMf

[Guest guest]

Rheumatology

Variability in the Traditional (TCM) Diagnoses and

Herbal Prescriptions Provided by Three TCM Practitioners for 40

Patients With Rheumatoid Arthritis

http://mp.medscape.com/cgi-bin1/DM/y/er1s0EDHzl0DzC0GpwQ0E7

Have you ever considered alternative medicine for your patients but

wondered about the evidence behind their effectiveness? If so, then

read this Journal Scan summary by Robert I. Fox, MD, PhD. The study

compared the pattern of diagnosis and treatment by traditional Chinese

medicine (TCM) practitioners in 40 patients with rheumatoid arthritis

(RA). The findings are interesting, demonstrating a low level of

agreement among experienced practitioners of TCM for the diagnosis and

herbal treatment of RA.

Helen Fosam, Program Director, Medscape Rheumatology

 

 

 

Oakland, CA 94609

 

 

 

[Guest guest]

Studies like these show are interesting but the conclusions show nothing more

than the

prejudices of the writer. Have them take a semester of TCM...

doug

 

 

 

The high level of use of TCM therapies by patients, healthcare providers, and

institutions

has made it imperative that physicians consider their ethical obligations when

recommending, tolerating, or prescribing these therapies. The major relevant

issues are

the severity and acuteness of illness; the curability of the illness by

conventional forms of

treatment; the degree of invasiveness, associated toxicities, and side effects

of the

conventional treatment; the availability and quality of evidence of utility and

safety of the

desired TCM treatment; the level of understanding of risks and benefits of the

TCM

treatment combined with the patient's knowing and voluntary acceptance of those

risks;

and the patient's persistence of intention to use TCM therapies.[31]

 

In summary, Zhang and colleagues[1] demonstrate a low level of agreement among

experienced practitioners of TCM for the diagnosis and herbal treatment of RA.

This

probably reflects that the RA (as defined in Western medicine) does not clearly

fit into a

single TCM category.[2] Although RA patients are recognized to have subsets in

Western

medicine, the subsets in TCM (defined by Bi excess and deficiency) do not

correspond to

the clinical and laboratory RA subsets defined in Western medicine. This lack of

agreement

even among experienced TCM practitioners will create difficulty in the

communication

between Western practitioners, TCM practitioners, and our patients.

 

Where does this leave the general rheumatologist? Rheumatologists must develop a

treatment plan that is clinically sound, ethically appropriate, and targeted to

the unique

circumstances of individual patients. Physicians are encouraged to remain

engaged in

problem solving with their patients who use TCM and to attempt to elucidate and

clarify

the patient's core values and beliefs when counseling about TCM therapies. The

patients

must understand the potential for interaction with their Western medicines and

the

potential toxicities of the herbs, as physicians may be medically legally liable

if they

encourage the use of agents that lead to toxicity.[32]

 

 

, " " <alonmarcus@w...>

wrote:

> Rheumatology

> Variability in the Traditional (TCM) Diagnoses and

> Herbal Prescriptions Provided by Three TCM Practitioners for 40

> Patients With Rheumatoid Arthritis

> http://mp.medscape.com/cgi-bin1/DM/y/er1s0EDHzl0DzC0GpwQ0E7

> Have you ever considered alternative medicine for your patients but

> wondered about the evidence behind their effectiveness? If so, then

> read this Journal Scan summary by Robert I. Fox, MD, PhD. The study

> compared the pattern of diagnosis and treatment by traditional Chinese

> medicine (TCM) practitioners in 40 patients with rheumatoid arthritis

> (RA). The findings are interesting, demonstrating a low level of

> agreement among experienced practitioners of TCM for the diagnosis and

> herbal treatment of RA.

> Helen Fosam, Program Director, Medscape Rheumatology

>

>

>

> Oakland, CA 94609

>

>

>