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Pharm 5018 ETSU

ch 10 Herbal and Complementary Therapies

History Ancient Egyptians used many herbal remedies. Greek and Roman herbal therapies were based on principles of the four humors. United States Significant growth in use in past 20 years
History There is a belief that herbal medicines are safer and have less harmful side effects. U.S. patients self-medicate and often do not tell their providers.
Herbal Medicine Definitions Phytomedicine is defined as “the practice of using plants/plant parts to achieve therapeutic cure. An herb is any plant part or plant used for its therapeutic value.
Herbal Medicine Definitions Pharmacognosy is the branch of pharmacology that uses the chemicals from plants, molds, fungi, insects, and marine animals for their medicinal value.
Herbal Medicine Western herbal medicine Primarily classified according to therapeutic properties and constituents of the plant Chinese herbs
Herbal Medicine The principles of herbal therapy are based on plant’s cycle of growth, characteristics of the plant, and underlying condition of the individual. Health is sustained by having a free flow of energy (Qi)/ Yin and yang
Herbal Medicine Wind, damp, hot, cold, dry, and wet Herbs are classified by their energies, quality, season, tastes, directions, and actions on the body.
Ayurvedic Medicine Ayurvedic medicine is the oldest form of medicine. Defined as the study of life, ayur means “life” and veda means “to study.” Herbs are used in massage oils, food, aromatherapy, and taken orally.
Ayurvedic Medicine In the tridosha system three doshas exist: Vata (air/ether), which corresponds to the nervous system and movement/Pitta (fire/water), representing transformation, circulation, warmth, and digestion
Ayurvedic Medicine Kapha (water/earth) representing nourishment, solidity, and the formative aspects of tissue, fluid, and bone/The goal of therapy is to counter excess or deficiency first with food and spice and then support it with specific herbal therapy.
Herbal Safety Guidelines for safe herbal practice est by American Herbal Guild/There can be wide variations in components of herbs based on growing conditions. In US, herbs are considered food and are not regulated by the U.S. Food and Drug Administration.
Evidence for Use of Herbs Natural Standard is a complementary medicine grading system. See: The Jadad scoring system of study quality
Evidence for Use of Herbs A Jadad score of 0 to 5 is given, with 5 being the highest quality study/Natural Standard evidence rating method is graded on a scale from A to F/“A” indicates strong scientific evidence of the benefit of the therapy; “F” suggests strong negative scientific evidence.
Evidence for Use of Herbs Healthnotes’ The Natural Pharmacy Evaluates the current state of evidence regarding herbs and nutritional supplements
Evidence for Use of Herbs Rakel Evidence vs. Harm Scale Uses the Strength of Recommendation Taxonomy (SORT) to rate the scientific evidence of integrated medicine treatments. Cochrane Database of Systematic Reviews
Evidence for Use of Herbs Cochrane Collaboration produces reviews of evidence/German Commission E Monographs German federal organization that determines the efficacy and safety of herbs and supplements sold in Germany
Evidence for Use of Herbs American Botanical Council Nonprofit educational and research organization dedicated to the science of herbal medicine
Evidence-Based Model (EBM) EBM is the gold standard of care. Evaluating complementary and alternative medicine (CAM) therapies
Evidence-Based Model (EBM) Ayurvedic or traditional Chinese medicine (TCM) uses the synergistic properties of the whole plant with the symptoms of the patient consuming it/The scientific method cannot be used to measure ideas and practices that have yet to be physically defined by Western science.
Evidence-Based Model (EBM) Outcomes in TCM and Ayurvedic medicine are determined largely by empirical rather than experimental diagnostic measures. Example: changes in a person’s tongue coat and pulse
Western Herbs Anxiety: kava, mugwort, wormwood, pill-bearing spurge, and passion flower Insomnia: mugwort, melatonin, valerian, passion flower, and chamomile Depression: St. John’s Wort
Western Herbs Confusion and forgetfulness: ginkgo, ginseng, and chaparral/Gastrointestinal problems/Constipation: cascara, castor bean, and senna/Indigestion and heartburn: caraway, licorice, and papaya enzyme
Western Herbs Pain/Arthritis: glucosamine and chondroitin Muscle and ligament pain: wintergreen oil and liniments Headache and migraine: feverfew
Traditional Chinese Medicine TCM is part of a holistic approach to healing that is most effective when combined with other TCM therapies/Acupuncture, manipulative therapies (tui na), food, and movement (qi-gong and tai ji )
Traditional Chinese Medicine The four energies Cold, hot, warm, and cool The five flavors Pungent (or acrid), sweet, sour, bitter, and salty
Traditional Chinese Medicine The four movements Upward, downward, floating, and sinking
Traditional Chinese Medicine Meridian routes Pathway of energy identified in TCM that corresponds to the 12-organ systems that the herb can enter and move through
Traditional Chinese Herbs A Chinese herb will be classified by its action to clear heat, stop wind, or reduce fire. Chinese herbal formulas
Traditional Chinese Herbs Classic formulas King herb and subject herb Assistant herbs
Traditional Chinese Herbs Administering Chinese herbs: Decoction/Powders/ Tablet Rules: timing, temperature, and not accompanying the herbal formula with a tea
Ayurvedic Herbs Tridoshic theory Six basic tastes: sweet, sour, salty, pungent, astringent, and bitter Food treats disease.
Ayurvedic Herbs Sweet, sour, and salty tastes reduce vata. Bitter, pungent, and astringent tastes enhance vata. Astringent, bitter, and sweet tastes reduce pitta.
Ayurvedic Herbs Sour, salty, and pungent tastes enhance pitta. Bitter, pungent, and astringent foods reduce kapha. Sweet, salty, and sour tastes enhance kapha.
Herbal Preparations Bolus: suppository inserted into the rectum Compress and fomentation: applying herbs externally to the body
Herbal Preparations Liniments: warming herbal extracts rubbed in the skin Oils: concentrated extracts used for massaging the body/Capsules or pills
Herbal Preparations Poultices and plasters: topical applications of powdered, crushed, or mashed herbs usually applied moist, either hot or warm, and left on an area on the body for 12 to 20 hours Mixtures for smoking: herbs that patients smoke
Herbal Preparations teas: strongest medicinal effect of any preparation Tinctures: extracts of herbs preserved in alcohol or vinegar
Considerations for the ANP Respect the rights of patients to choose their own therapies. Educate yourself. Understand the known risks of CAM therapies.
Considerations for the ANP Refer to trained/certified CAM providers. Keep an open mind.
Created by: palmerag



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