TRADITIONAL MEDICINE’S CONCEPT OF OSTEOPOROSIS NGUYEN THI BAY NGUYEN THI BAY Faculty of Traditional medicine Faculty of Traditional medicine University of Medicine and Pharmacy, HCMC University of Medicine and Pharmacy, HCMC
Apr 01, 2015
TRADITIONAL MEDICINE’S CONCEPT
OF
OSTEOPOROSIS
TRADITIONAL MEDICINE’S CONCEPT
OF
OSTEOPOROSIS
NGUYEN THI BAYNGUYEN THI BAYFaculty of Traditional medicineFaculty of Traditional medicine
University of Medicine and Pharmacy, HCMCUniversity of Medicine and Pharmacy, HCMC
IntroductionIntroduction
Physiology and Pathology of Physiology and Pathology of Traditional MedicineTraditional Medicine
Yin – YangYin – Yang theory theory
Five Elements Five Elements theorytheory
5 organs of the body5 organs of the body Materials help the body to workMaterials help the body to work
Fire HeartFire Heart
Wood Wood LiverLiver
Earth Earth SpleenSpleen
Water Water KidneyKidney
Metal Metal LungLung
SemenSemen
EnergyEnergy
BloodBlood
SpiritSpirit
Body fluidBody fluid
IntroductionIntroduction
Wood LiverWood Liver Water KidneyWater Kidney
Unbalance of Energy – Blood Unbalance of Energy – Blood & Yin – Yang& Yin – Yang
Osteolysis > OsteogenesisOsteolysis > Osteogenesis
Vague spinal painVague spinal pain
Pain along the length of bone, tired musclePain along the length of bone, tired muscle
Pain increases when sitting or standing too Pain increases when sitting or standing too long, when changing position…long, when changing position…
Decreased bone massDecreased bone mass
Combined with:Combined with:
Functions of the Wood LiverFunctions of the Wood Liver
Controls TENDONControls TENDON
Controls CATALYSTSControls CATALYSTS
Store BLOODStore BLOOD
MobilityMobility
BirthBirthGrowthGrowth
Maintains the Maintains the
quick and strong quick and strong
mobility of the mobility of the
skeletal systemskeletal system
Nurture and assist skeletal Nurture and assist skeletal
movements and the movements and the
vegetal nervous systemvegetal nervous system
Belongs to Movement Belongs to Movement
and Developmentand Development
Functions of the Water KidneyFunctions of the Water Kidney
Store Store Vital Genital Vital Genital
SubstancesSubstances
Controls Controls Bone and Bone and
Bone MarrowBone Marrow
Controls Controls Genital Genital
OrgansOrgans
Control and maintain Control and maintain
the bone’s strengththe bone’s strength
Related to the causes Related to the causes
of Osteoporosisof Osteoporosis
Etiology – Mechanism – TreatmentEtiology – Mechanism – Treatment
Congenital InsufficiencyCongenital Insufficiency
Internal causesInternal causes
Age accumulationAge accumulation
Energy – Blood Energy – Blood
Wood Liver – Water Kidney Wood Liver – Water Kidney
Re-establishment of Re-establishment of YIN – YANGYIN – YANG balance balance
Re-establishment of Re-establishment of Energy – Blood Energy – Blood balancebalance
Tonify Tonify Wood Liver – Water KidneyWood Liver – Water Kidney
Ancient medical formulaeAncient medical formulae
has the general effects of:has the general effects of:
• Tonify the Tonify the Liver – KidneyLiver – Kidney
• Establishment the balance of Establishment the balance of Energy – BloodEnergy – Blood
Rehmannia Rehmannia glutinosaglutinosa
Rhizoma Rhizoma HomalomenaeHomalomenae
Anglelica Sinensis Anglelica Sinensis DielsDiels
Eucommia Eucommia ulmoides Oliv.ulmoides Oliv.
Achyranthes Achyranthes bidentata Blumebidentata Blume
Objective of StudyObjective of Study
Evaluate the effectiveness of these formulae:Evaluate the effectiveness of these formulae:
Formula 1: “Luc vi” 6 Formula 1: “Luc vi” 6 medicinal plantsmedicinal plants
Formula 2: “Doc hoat” Formula 2: “Doc hoat” 12 medicinal plants12 medicinal plants
on osteoporosis patientson osteoporosis patients
Study of Formula 1 – Tonify the LiverStudy of Formula 1 – Tonify the Liver
Study design:Study design: single-blind clinical trial single-blind clinical trial
Patients:Patients: Women aged > 50, menopausal, diagnosed Women aged > 50, menopausal, diagnosed
with Osteoporosiswith Osteoporosis
Venue: Venue: Hospital 175 Ho Chi Minh CityHospital 175 Ho Chi Minh City
Medication:Medication:
Trial group: Trial group: 6 herbs 6 herbs capsule 500mg capsule 500mg
Control group: Control group: Placebo: Malt – capsule 500mgPlacebo: Malt – capsule 500mg
Duration: Duration: Continuous observation in and after 12 Continuous observation in and after 12
monthsmonths
Observation and EvaluationObservation and Evaluation
Pain evaluation by QDSA (Saint – Antoine):Pain evaluation by QDSA (Saint – Antoine):
Patients’ complaintsPatients’ complaints
Spontaneous movement decreasedSpontaneous movement decreased
Pain-killers demandedPain-killers demanded
Bone mineral density (BMD) by DXA Bone mineral density (BMD) by DXA method (T-score < -1.6)method (T-score < -1.6)
Meunier index by Spinal X-ray (>10)Meunier index by Spinal X-ray (>10)
ResultResult
N = 68 patientsN = 68 patients
Calcaneus BMD by DEXA methodCalcaneus BMD by DEXA method
Trial groupTrial groupControl groupControl group
BeforeBefore 6 6 monthsmonths
12 12 monthsmonths Dr. Phan Thi Hoa et al.Dr. Phan Thi Hoa et al.
175 Hospital175 Hospital
p < 0.05
Trial groupTrial group Control groupControl group
Percentage of patients with changed Calcaneus BMD by DEXA Percentage of patients with changed Calcaneus BMD by DEXA
methodmethod
6 months 12 months6 months 12 months 6 months 12 months6 months 12 months
IncreasedIncreased
ConstantConstant
DecreasedDecreased
Dr. Phan Thi Hoa et al.Dr. Phan Thi Hoa et al.
175 Hospital175 Hospital
Evaluate patients’ complaints of spinal pain (QDSA)Evaluate patients’ complaints of spinal pain (QDSA)
Before 6 months 12 months
Trial groupTrial groupControl groupControl group
Dr. Phan Thi Hoa et al.Dr. Phan Thi Hoa et al.
175 Hospital175 Hospital
Evaluate the decrease of spontaneous movements in patients Evaluate the decrease of spontaneous movements in patients with spinal back pain (QDSA)with spinal back pain (QDSA)
Trial groupTrial groupControl groupControl group
Before 6 months 12 months
Dr. Phan Thi Hoa et al.Dr. Phan Thi Hoa et al.
175 Hospital175 Hospital
Evaluate the demand of pain-killers by patients with spinal pain (QDSA)Evaluate the demand of pain-killers by patients with spinal pain (QDSA)
Trial groupTrial groupControl groupControl group
Before 6 months 12 months
Dr. Phan Thi Hoa et al.Dr. Phan Thi Hoa et al.
175 Hospital175 Hospital
Study of Formula 2Study of Formula 2
Study design:Study design: patients diagnosed with osteoporosis, patients diagnosed with osteoporosis,
no gender biasno gender bias
Venue:Venue:
33rdrd branch, University Medical Center, Ho Chi Minh City branch, University Medical Center, Ho Chi Minh City
Traditional Medicine Hospital, Ho Chi Minh CityTraditional Medicine Hospital, Ho Chi Minh City
Traditional Medicine Institute, Ho Chi Minh CityTraditional Medicine Institute, Ho Chi Minh City
Medication:Medication:
Trial group: Trial group: 12 herbs – capsule 500mg12 herbs – capsule 500mg
Control group: Control group: Placebo: malt – capsule 500mgPlacebo: malt – capsule 500mg
Duration: Duration: 12 months12 months
ResultResult
n = 180 patientsn = 180 patients
Age 45 – 70, men and womenAge 45 – 70, men and women
29% of patients have increased BMD29% of patients have increased BMD
76% of patients have lessened pain after 4 weeks76% of patients have lessened pain after 4 weeks
88% of patients have improved mobility after 4 weeks88% of patients have improved mobility after 4 weeks
Dr. Do Tan Khoa et al.Dr. Do Tan Khoa et al.
Traditional Medicine HospitalTraditional Medicine Hospital
Conclusion 1Conclusion 1
OsteoporosisOsteoporosis
Energy – Blood Energy – Blood
Wood Wood Liver Liver
Water Water Kidney Kidney
Terminology – Name of diseaseTerminology – Name of disease
MechanismMechanism
Same consequence: OsteoporosisSame consequence: Osteoporosis
Conclusion 2Conclusion 2
Result of Formula 1 (Tonify Kidney):Result of Formula 1 (Tonify Kidney):
BMD increases after 12 months of medicationBMD increases after 12 months of medication
Result of Formula 2 (Tonify Liver – Kidney):Result of Formula 2 (Tonify Liver – Kidney):
BMD increases after 6 and 12 months of medicationBMD increases after 6 and 12 months of medication
Evidence:Evidence: In Traditional Medicine theory, the In Traditional Medicine theory, the
functions of Liver – Kidney are related to the functions of Liver – Kidney are related to the
activities of the skeletal systemactivities of the skeletal system
Conclusion 3Conclusion 3
Traditional Medicine has a vital role in the Traditional Medicine has a vital role in the
TREATMENT and PREVENTION of OsteoporosisTREATMENT and PREVENTION of Osteoporosis
Result of Formula 1 (Tonify Kidney):Result of Formula 1 (Tonify Kidney):
BMD increases after 12 months of medicationBMD increases after 12 months of medication
Result of Formula 2 (Tonify Liver – Kidney):Result of Formula 2 (Tonify Liver – Kidney):
BMD increases after 6 and 12 months of medicationBMD increases after 6 and 12 months of medication
AcknowledgementAcknowledgement
Thank you,Thank you,
Dr. Phan Thi HoaDr. Phan Thi Hoa
Dr. Do Tan KhoaDr. Do Tan Khoa
The Director Boards of Hospital 175, The Director Boards of Hospital 175,
Traditional Medicine Hospital, Traditional Traditional Medicine Hospital, Traditional
Medicine Institute, and the 3Medicine Institute, and the 3rdrd branch of branch of
University Medical CenterUniversity Medical Center
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