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OBJECTIVE@#To assess the current state of cancer treatment incorporating Thai traditional medicine (TTM) and to identify problems in the system, by using the health system framework of the World Health Organization.@*METHODS@#A qualitative study was conducted by interviewing three groups of people involved in the healthcare system. The groups were constructed via purposive sampling of patients with cancer, caregivers and service providers. The study groups included 37 individuals from five TTM hospitals. In-depth interviews were conducted from October 2017 to March 2018. The interview questions were developed based on the six building blocks of a health system framework. Free form answers from participants were analyzed and interpreted to develop the study conclusions.@*RESULTS@#All five TTM hospitals provided treatment to patients with cancer based on provincial public health policy. The policy allows patients with cancer to obtain TTM services in outpatient and inpatient departments and via home visits; most patients used outpatient services. The TTM services were primarily provided by TTM practitioners and included massage, herbal steam, herbal compress and meditation. Herbal medicines were widely used and included Benja-amarit, an anticancer formulation made from Wat Khampramong and Phytoplex. The problems included poor acceptance of TTM practitioners by other healthcare practitioners, lack of experience among TTM practitioners in treating patients with cancer, lack of herbal medicine research trials, contamination in herbal medicine preparations and absence of practical treatment guidelines.@*CONCLUSION@#TTM is an alternative treatment modality for patients with cancer and is supported by a national policy in Thailand. To increase accountability to patients and other practitioners, TTM treatments should be refined to rely on scientific principles and practitioners of TTM should receive academic training. Practical treatment guidelines need to be established and thoroughly disseminated to TTM practitioners.
RESUMEN
<p><b>BACKGROUND</b>Allergic rhinitis is a nasal mucosa inflammatory disorder that is induced by exposure to an allergen which results in four major symptoms, including anterior or posterior rhinorrhea, sneezing, nasal itching and nasal congestion. Allergic rhinitis may result in sleep disturbance, fatigue, depression of mood-cognitive function and quality of life impairment.</p><p><b>OBJECTIVE</b>This study examined the efficacy and safety of herbal steam bath used for the reduction of allergic rhinitis symptoms, and evaluated treatment satisfaction and improvements in quality of life among participating patients with allergic rhinitis.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTION</b>A single-blind randomized controlled trial was conducted at Thai Traditional and Alternative Medicine Hospital between June and December 2016, using 64 subjects, equally divided into two groups. The treatment group received herbal steam bath and the control group received steam bath without herbs for 30 min 3 times a week for 4 consecutive weeks.</p><p><b>MAIN OUTCOME MEASURES</b>Allergic rhinitis symptoms, such as itchy nose, runny nose, sneezing, nasal congestion and watery eyes, were measured using the visual analog scale at weeks 0, 1, 2, 3 and 4. Quality of life was assessed at week 0 and week 4.</p><p><b>RESULTS</b>The characteristics (sex, age, marital status, education, allergic rhinitis symptoms and frequency of symptoms) at the baseline were not statistically different (P > 0.05) between the two test groups. Anterior or posterior rhinorrhea symptoms, including sneezing, nasal itching and nasal congestion, were statistically reduced over the course of the treatment, but reductions were not significantly different between the control and treatment groups. The treatment group, however, was shown to be significantly more satisfied with the treatment than the control group (P < 0.05).</p><p><b>CONCLUSION</b>Both treatments appear to be able to significantly reduce the symptoms of allergic rhinitis. However, there was no difference in the effectiveness of steam bath with herbs and steam bath without herbs.</p><p><b>TRIAL REGISTRATION</b>This trial was registered in the Thai Clinical Trial Registry with the identifier TCTR20170712002.</p>