Transcript Herbal medicine and TCM prescriptions

Introduction of Herbal
Medicine…
COLIN Chan
A) TCM Practice in Singapore
Legislation and Registrations
Regulation of TCM Practice
1.
The Traditional Chinese Medicine Practitioners Act was
passed on 14 Nov 2000.
2.
The registration of TCM Acupuncturist started in 2001.
3.
The registration of TCM physicians in 2002.
4.
With effect from 1 January 2004, those who wish to
practice the prescribed practice of TCM are
required to be registered with the TCM
Practitioners Board and possess valid practicing
certificates.
Complimentary medicine including Traditional Chinese
Medicine (TCM). MOH , Singapore.
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Types of Registrations
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Full Registration.
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Conditional registration.
Proceed to the application of practicing certificate.
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The term “Traditional Chinese General Medicine”
Means:
1.
Acupuncture.
2.
Diagnosis, treatment, prevention or alleviation of any
disease or any symptom of a disease or the
prescription of any herbal medicine.
3.
The regulation of the functional states of the human
body, on the basis of traditional Chinese Medicine.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
The term “Herbal Medicine”
Means:
1.
Any material or product known or claimed to have
therapeutic or other heath benefits which contains
either raw or processed ingredients of plant,
inorganic or animal origin.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
Standard of good TCM practice …
Must include:
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5.
Good history taking and appropriate TCM clinical
examination.
No remote initial consultations.
Only use appropriate and accepted methods of
TCM treatment.
Not to offer treatment packages in a form of
“guarantee of a cure”.
Referrals.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
The Medical Records …
Must include:
1.
2.
3.
4.
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Particulars of patient. (Name, IC, Gender, Age, Add, Contact)
Drug allergies and medical history.
Main complaint.
Other observations.
Diagnosis.
Treatment.
Prescription.
Instructions to patient.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006
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Prescription…
Must include:
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Name and signature of TCM physician.
Name and address of place of practice.
Name and address of patient.
Date of prescription.
Name and dosage of herbal medicine.
Total amount to be supplied.
Route of administration.
Preparation method.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
TCM is the study of…
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TCM theories
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TCM diagnostic doctrines, principal of treatment and treatment
methods
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Herbal medicine and TCM prescriptions
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Acupuncture
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Ailments of different disciplines
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Diet Therapy/Tuina/History/Case studies etc.
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B) Before the application of Herbal
Medicine…
TCM diagnostic doctrines
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4 analytical methods. (collect information)
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8 parameters. (categorize conditions)
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Diagnosis based on Qi, blood and body fluid.
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Diagnosis based on 6 meridians.
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Diagnosis based on organs/viseras.
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Diagnosis based on pathogens etc.
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TCM Analytical methods
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Observation (tongue). 望
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Auscultation/Olfaction. 闻
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Interrogation (Asking). 问
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Palpation (pulse). 切
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Observation of the
tongue …
Root – Kidney (4th)
Margin – Liver/Gall
Bladder (2nd)
Center –
Spleen/Stomach (3rd)
Tip – Heart/Lung (1st)
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Body and Coating
color, shape, texture,
movement, nature
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Example …
Normal
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TCM diagnostic method
Palpation 切
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Pulse (Very common, usually radial pulse).
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Chest.
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Abdomen.
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Analysis of the
pulse …
Include:
Speed.
Strength.
Shape and dynamics.
Flow and regularity etc.
Front: Cun 寸
Middle: Guan 关
Rear: Chi 尺
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Example …
Some examples:
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Floating.
Deep (sink).
Late (delayed).
Rapid.
Smooth.
Un-smooth.
Bounding.
Soft and floating.
Full.
Thin and small.
Abrupt and irregular.
Slow and irregular etc.
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The
pulse …
Great clinical significance in TCM…
1.
When disease occurs, qi and blood vary leading to pulse change.
2.
Pulse examination can establish…
the health status of the patient,
the characteristics of causative factors,
the progression and changes of ailments.
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Applications of the
8 parameters …
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Exterior / Interior (depth).
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Cold / Hot (characteristics).
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Deficiency / Excess (aggressiveness).
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Yin / Yang (Over-all status).
It often combines, interact, inter-change in clinical settings.
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Take 5 …
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Principal of treatment …
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Principal: As a basic guideline to treatment.
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Methods:
1.
Internal treatment (herbal medicine, diet therapy).
2.
External treatment (acupuncture, tuina, topical).
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C) About TCM Herbal
Medicine
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TCM Treatments …
The use of CMM:
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Legally available in Singapore (GMP standard, HSA tested).
Reasonable quantities.
Name of medicine as used in CMM.
PS: CMM: Chinese Herbal Medicine Materia Medica
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
Types of CMM…
1.
Plant type.
(root / stem / bark / twig / bud / petals / flower
/ leaves / fruit / seed,etc) .
2.
Animal origin.
3.
Insects group.
4.
Marine source.
5.
Mineral source.
PS: CMM: Chinese Herbal Medicine Materia Medica.
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Treatment methods
Mainly 11 ways (internal)…
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Perspiration (Han)
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Sinus clearing (Kai Qiao)
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Emetics (Tu)
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Calming (Zheng Nai)
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Purging (Xia)
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Astringent (Gu She)
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Harmonize (He)
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Warm (Wen)
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Clear (Qing)
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Tonify (Bu)
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Disperse (Xiao)
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Herbal Medicine
The study of Herbal Medicine in…
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Categories.
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Properties and Characteristics.
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Harvest and Storage and treatment of herbs.
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Clinical usage (pairing, dosage, preparation
and consumption etc).
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Herbal Prescriptions.
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Herbal Medicine and Prescriptions
Categories…
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Dispersing exogenous pathogens agents.
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Purging agents.
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Harmonizing agents.
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Heat clearing agents.
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Dampness dispersing agents.
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Diuretic agents.
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Anti-arthritic agents.
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Warming agents.
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Clearing sinuses agents.
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Herbal Medicine and Prescriptions
Categories…
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Calming agents.
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Liver wind calming agents.
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Qi regulating agents.
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Heat clearing agents.
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Blood regulating agents.
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Digestive agents.
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Cough and phlegm agents.
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Tonic agents.
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Astringent and anti worm agents.
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Properties and Tastes of Herbs
The 4 properties are…
The 5 tastes are…
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Cold
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Acrid
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Cool
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Sweet
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Hot
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Sour
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Warm
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Bitter
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(Neutral)
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Salty
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(Bland)
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Examples of herb…
Examples of herbs…
Examples of herbs…
The Use of Herbal Prescriptions in Western clinical settings
Commonly given as supplements…
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Single drug (Herbal) prescription
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Complex drug (Herbal) prescription
Single drug (Herbal) prescription
Herbal Ma Huang
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Property: Warm
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Taste: Acrid
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Channel: Lungs and Kidney
Traditional usage:
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Exogenous febrile disease of the wind-cold type
Research:
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Active ingredient: ephedrine
Modern usage:
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Cough mixtures
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Bronchodilators
Single drug (Herbal) prescription
Herbal Gan Huang Cao (Penthori Chinenesis)
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Property: Cold
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Taste: Bitter
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Channel: Liver , Gall Bladder and Kidney
Traditionally usage:
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Oedema, injuries, amenorrhea
Research:
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Active ingredient: Quercetin and Gallic acid
Modern usage:
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Jaundice
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Hepatitis, Fatty liver, Ca Liver
Complex drug (Herbal) prescription
Capsule Artrex
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Combination of 4 types of herbal medicine
Withania Somnifera, Boswellia Serrata
Curcuma Longa, Zingiber Officinale
Research:
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Active ingredient: Contains immuno-boosters,
analgesics agents, antiarthritic agents, anti wind agents
Modern usage:
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Osteo-arthritis
Withania Somnifera (Immunobooster effect)
Boswellia Serrata (Antiinflam. effect)
Curcuma Longa
(Analgesic effect)
Zingiber Officinale
(Anti-arthritic effect)
Modern development of Herbs
Example: Chrysanthemum…菊花
TCM: Slightly sweet, Bitter, Cold.
Lung and Liver Channel.
Clearing of heat agent.
Modern: Anti bacterial and virus effects.
Streptococcus, Staphylococcus, Pseudomonas
TB Bacillus, Flu Virus, Skin Virus.
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TCM physicians are not allowed to
prescribe/dispense any western
medicines.
Ethical Code and Ethical Guidelines For TCM Practitioners,
TCMPB Singapore January 2006.
Copy right: : Colin Chan
Conclusion
1.
Getting more common in western clinical usage.
(as Supplements).
2.
Not able to fulfill the full principle of treatment in
TCM
3.
Disadvantages noted.
4.
Technical issues noted.
The End