Traditional Chinese Medicine for hot flashes & associated symptoms: Evidence from a systematic review Lisa J Taylor-Swanson, MS, PhD Student Nancy Fugate Woods, PhD, Professor, Dean Emeritus Ellen Mitchell, PhD, Associate Professor Emeritus Janet Schnall, MS, AHI, Librarian 2012 State of the Science Congress on Nursing Science September 13-15, 2012 Washington, DC
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Lisa J Taylor-Swanson , MS, PhD Student Nancy Fugate Woods , PhD, Professor, Dean Emeritus
Traditional Chinese Medicine for hot flashes & associated symptoms: Evidence from a systematic review. Lisa J Taylor-Swanson , MS, PhD Student Nancy Fugate Woods , PhD, Professor, Dean Emeritus Ellen Mitchell , PhD, Associate Professor Emeritus Janet Schnall , MS, AHI, Librarian. - PowerPoint PPT Presentation
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Traditional Chinese Medicine for hot flashes & associated symptoms: Evidence from asystematic review
Lisa J Taylor-Swanson, MS, PhD Student
Nancy Fugate Woods, PhD, Professor, Dean Emeritus
Ellen Mitchell, PhD, Associate Professor Emeritus
Janet Schnall, MS, AHI, Librarian
2012 State of the Science Congress on Nursing ScienceSeptember 13-15, 2012Washington, DC
Background
• 80% of women in the US experience menopausal transition (MT) symptoms – usually several symptoms
• Hormone therapy concerns have led to increased utilization of Complementary & Alternative Medicine (CAM)
• Traditional Chinese Medicine (TCM) used to promote women’s health…for awhile
Background
• TCM differential diagnoses vary by clusters of symptoms presented – congruent with study design.
• No systematic review thus far on TCM for multiple MT symptoms.
Purpose
• To review studies of TCM used to treat MT clusters of symptoms (hot flashes, sleep, cognitive function, mood & pain) during the menopausal transition and early post-menopause.
• To generate information useful for clinicians.
Methods
• We reviewed 13 controlled clinical trials (CCTs) of TCM’s effects on HFs & at least 1 other associated symptom including sleep, cognitive function, mood, and pain.
• 8 Acupuncture, 4 Chinese Herbal Medicine (CHM), 1 Moxibustion (“Moxa”) papers.
• Women studied were in the menopausal transition and early post-menopause.
Description of Studies
Study population, location
USA, Norway, Korea, Turkey, Netherlands, China, Hong Kong, Australia
• Acupuncture, Moxibustion and Kun Bao Wan/Xiao Yao Wan plus counseling showed the most broad results. (1 study each)
• 4 CCTs – HFs only
Results - Continued
• Initial findings of significant improvement with 12 weeks’ acupuncture care were no longer present at 6 & 12 months follow-up.
• 5 of 8 CCTs compared acupuncture with sham acupuncture. 1 of these 5 studies found acupuncture and sham acupuncture were both significantly beneficial. (Venzke, 2010).
• No reports of serious harm or adverse events.
Limitations
• Scales used varied: Diary, BDI, MENQOL, Green (HF, psych), WHQ (HF, sleep), MRS (HF, pain, psych)
• Dose – What is an “acupuncture dose”?• Sham acupuncture – it is a sham?• Various CHM formulas, doses, durations studied.• TCM as practiced in clinic was not evaluated (many
tools used simultaneously).• Traditional Chinese Medicine (TCM) differential dx
& others used a standardized protocol.
Conclusions
• TCM offers promise in the management of hot flashes during the menopausal transition and early post-menopause as a safe & possibly effective tx.
• Standardization of study design and methods is needed.
• Longitudinal studies needed – what is the effectiveness trajectory? Booster sessions?
Thank You!
SoN Travel Fund & de Tornyay CenterSchool of Nursing, University of WA
National Institute for Nursing ResearchNIH NR01 04141 and NINR, NIH, P50-NR-02323, P30-NR04001
ARCS Foundation FellowshipSeattle Chapter
Lisa J Taylor-SwansonPhD Student & Licensed Acupuncturist