an introduction to integrative east west medicine
TRANSCRIPT
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An Introduction to
Integrative East West Medicine
Malcolm Taw, MD
UCLA Center for East West Medicine
Department of Medicine
David Geffen School of Medicine, UCLA
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Outline
Introduction to Integrative East West Medicine
An Overview of the UCLA Center for East West
Medicine
Clinical/Research Interests
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Modern Traditional
Western Medicine Chinese Medicine
(MWM) (TCM)
Reductionistic Holistic
Microscopic Macroscopic
Structure Function
Quantitative Qualitative
Separation of Preservation of
Mind-Body Mind-Body
Philosophy
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Origin of Reductionism
George B. Murray, MD
Director of Psychosomatic Program
Harvard Medical School
Limbic Music – (Massachusetts General Hospital: Handbook
of General Hospital Psychiatry, 4th ed, p. 12)
“In reductionism what one reduces and gets rid of is,
in fact, mind …The culprit for this great, supposed split
between brain and mind is usually thought to be Descartes
… One often hears the phrase ‘Cartesian dualism’.”
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Western Eastern
Alphabet Pictures
Several words Few characters
Phonetic Not phonetic
Complex grammar Minimal grammar
Language
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Evolution of Chinese Characters
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Natural image Ancient depiction Modern character
Mountain
Moon
Sun
Morning
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Integrative East West Medicine(Inherent Barriers)
• Translation often is not one-to-one
• Lack of equivalent concepts in medicine Ex: TCM has no nervous/endocrine system
Western medicine lacks concept of
dampness/wind
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Integrative East West Medicine(Common ground)
MWMTCM
Man
Environment
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Yin & Yang Theory
Two extremes brought into dynamic balance
Black/White, Hot/Cold, Day/Night
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Yin & Yang Theory(Modern Western Medicine)
Hot/Cold (Physiologic temperature = 98.6 deg F)
Acid/Base (Physiologic balance pH = 7.4)
Sympathetic/Parasympathetic
Electrolyte disorders
Oxygen/CO2
Hyper/Hypothyroidism
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RESEARCH
CLINIC
EDUCATION
INTERNATIONAL
DEVELOPMENT
UCLA CENTER FOR
EAST-WEST MEDICINE
COMMUNITY OUTREACH
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UCLA Center for East-West
Medicine
MISSION: To improve health, well-being, and quality of
life by incorporating the best of Western and traditional
Chinese medicine.
PROGRAMS OF THE CENTER:
-- Clinical
-- Educational
-- Research
-- International
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- Affiliated UCLA Programs (centers, research
groups, and organizations actively involved in the
CCIM)
UCLA Brain Mapping Center
UCLA Brain Research Institute
UCLA Center for East-West Medicine
UCLA Center for Human Nutrition
UCLA CNS: Center for Neurovisceral Sciences &
Women's Health
UCLA/CURE/Brain Gut Research Group
UCLA Learning and Memory Project
UCLA Norman Cousins Center for
Psychoneuroimmunology
UCLA Opioid Research Center
UCLA Pediatric Pain Program
UCLA Pelvic Pain Clinic
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Features of the Clinic
Clinic StaffOver a dozen health care providers that include both
Western and Eastern trained physicians
Patient referralOver 12,000 patient visits a year
Primarily referred from specialists in the UCLA system
Patient population
Most patients exhaust other conventional treatments
Patients who fail or are intolerant of medications/surgery
Predominantly non-Chinese
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Chronic Pain Conditions
Neck/Low back/Pelvicpain
Headaches
Myofascial pain
Chronic Pain Syndrome
Fibromyalgia
Degenerative arthritis
Post surgical chronic pain
Patient Symptoms
Gastrointestinalcomplaints
Chronic fatigue
Anxiety/Depression
Sinusitis
Cancer related problems
Skin disorders
Women’s health relatedproblems
What disorders do we treat?
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Assess adequacy of any priorconventional work up and treatment
Complete health history includingpsychosocial, stress, sleep, nutritional,and other lifestyle factors
Conventional physical examsupplemented by palpation ofacupoints and TCM tongue diagnosis
Integrative East-West Approach
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TCM Approach to the Patient
Focus on enhancing the body’s
endogenous resistance (homeostatic
reserve) to disease
Restore normal balance and flow
Individualization of treatment
Less emphasis on specific causal
factors
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Patient Evaluation
MWM TCM
DiseasePattern (Zheng)
Diagnosis
History/ Physical Exam
Treat disease Treat symptom/
underlying cause
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Chinese Medicine Western Medicine
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Acupuncture
Trigger point
injections
Therapeutic
massage
Dietary and herbal
counseling
Mind-body exercises
Tai Chi
Patient education
Lifestyle
Nutrition
Acupressure/self-
massage
Therapeutic Modalities
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ComplementaryComplementary
& Alternative& Alternative
Medicine (CAM)Medicine (CAM)
Modern WesternModern Western
MedicineMedicine
mixingmixingtrue integrationtrue integration
Deleterious EffectsDeleterious Effectsadverse interactionsadverse interactions
fragmentation of carefragmentation of care
waste of resourceswaste of resources
cost-generatingcost-generating
iatrogenesisiatrogenesis
New ParadigmNew Paradigm safesafe
effectiveeffective
affordableaffordable
accessibleaccessible
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Clinical/Research Interests
Use of Integrative East-West Medicine to Treat:
1) Hypertension
- Acupuncture/Acupressure
- Addressing the Mind/Body Connection
- Dietary/Lifestyle changes
- Tai Chi
2) Disorders of the Ears, Nose & Throat
- Sinusitis - Allergic Rhinitis
- TMJ syndrome - Eustachian Tube Dysfxn
- Dizziness/Vertigo
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Clinical/Research Interests
3) Dermatologic Conditions
- Chronic Urticaria - Refractory Pruritus
- Atopic Dermatitis/Eczema
4) Chinese Herbal Medicine Clinical Pharmacolog
- Better understand herb-drug interactions
- Provide a safe & effective integrative therapeutic
model
- Compare/contrast MWM vs TCM pharmacologic
paradigms
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Prospective Pilot Study
Twenty patients with documented Chronic
Rhinosinusitis - screened by Otolaryngologist
at UCLA
Will enroll adults, 18-65 y.o. who are able to
give informed consent
Chronic Sinusitis Study Malcolm Taw MD, Chau Nguyen MD, Marilene Wang MD, and Ka-Kit Hui MD
UCLA Center for East-West Medicine
UCLA Division of Otolaryngology
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Obvious surgical candidates (ie. nasal
polyposis, allergic fungal sinusitis)
Autoimmune disorders
HIV+, hepatitis
Previous sinus surgery within 3 mos
Prior acupuncture within 2 mos
Exclusion Criteria
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Treatment Course
Weekly treatments x 8
Acupuncture, therapeutic acupressure/
massage, trigger point injections
TCM dietary/lifestyle counseling
Self acupressure
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Endpoints
QOL surveys
SF-36
Chronic Sinusitis Survey, SNOT-20
Taken at baseline, 2 months, 6 months,
and 1 year