Practicing traditional Chinese medicine in the COVID-19 pandemic in Switzerland - an exploratory study.

BACKGROUND: To curb the spread of the first wave of the COVID-19 pandemic, the Swiss government declared a state of health emergency and ordered a legal restriction concerning the opening of healthcare institutions. In this study, we aimed to assess the proportion of traditional Chinese medicine (TCM) physicians and therapists who consulted patients regarding COVID-19 during the first wave of the pandemic in 2020 in Switzerland, as well as the extent to which COVID-19 affected their practices during the same period. METHODS: A retrospective study was performed by using a questionnaire from January to April 2021 among a random sample of TCM physicians and therapists based in Switzerland. The survey included questions on demographic characteristics, opening status of practices, channels of communication used for the medical encounter, and experience in managing the prevention, acute, and recovery stages of COVID-19 infection. RESULTS: Among the 320 participants, 76% consulted a patient regarding COVID-19 at least once. Overall, physicians and therapists consulted more patients during recovery (76.3%) and prevention (67.8%) than during the acute stage (19.8%) of the disease. Acupuncture was the most frequently used technique among TCM therapists and physicians consulting for prevention (80.4%) and recovery (92.5%), whereas Chinese pharmacopeia was the most used technique among those consulting for the acute stage (59.3%). Of those who closed their practices from March to April 2020 but kept consulting, telephone (30.4%) and home visits (29.9%) were the two principal methods of consultation. CONCLUSIONS: The restriction concerning the opening of practices induced a loss of the health workforce, especially among TCM therapists. Nonetheless, TCM therapists and physicians consulted patients regarding COVID-19, especially during the recovery stage. As there is a demand for the use of TCM in the context of COVID-19, it raises the need for a better consideration of TCM in the Swiss health care system.

[Integrative medicine: scientific literature in 2021]. / Médecine integrative - Littérature scientifique en 2021.

To illustrate the novelties in integrative and complementary medicine in 2021, the authors present a selection of six articles. One of them is specifically related to COVID-19. The other articles deal with themes that are always relevant and where complementary approaches represent a real added value. Two articles focus on low back pain, a common problem in primary care medicine. The others examine acupuncture in the oncological context, the use of therapeutic suggestions in an operative context, and Tai Chi. The authors thus provide an overview of the range of possible complementary therapeutic approaches that are increasingly supported by evidence, inviting them to be better integrated into clinical practice.

Pour illustrer les nouveautés en médecine intégrative et complémentaire en 2021, les auteur·e·s présentent une sélection de six articles. L'un s'intéresse plus spécifiquement au Covid-19. Les autres touchent des thématiques qui restent toujours d'actualité et où des approches complémentaires peuvent représenter une réelle plus-value. Deux articles ont pour thème les lombalgies, problématique courante en médecine de premier recours. Les autres examinent l'acupuncture dans le contexte oncologique, l'utilisation de suggestions thérapeutiques dans un contexte opératoire, et le Tai Chi. Les auteur·e·s donnent ainsi un aperçu de l'éventail d'approches thérapeutiques complémentaires possibles et de plus en plus soutenues par la science, invitant à les intégrer de mieux en mieux dans la pratique clinique.

[Scientific literature on integrative medicine in 2020]. / Littérature scientifique concernant la médecine intégrative en 202.

Scientific research in integrative medicine has undergone significant development in recent years. Several studies published in 2020 focus on the management of chronic pain. Hypnosis has been shown to be as effective in analgesia as cognitive-behavioral therapy and therapeutic education. A study on chronic low back pain showed lower health care costs for patients using complementary medicine. Furthermore, the hypothesis of super responders to acupuncture treatment does not seem to be confirmed. Yoga could be a useful approach in the prevention of migraines. With respect to the management of COVID-19, the addition of traditional Chinese medicine to conventional treatments could reduce a number of symptoms and the length of hospital stays, although the quality of data is limited.

La recherche en médecine intégrative connaît un développement important depuis quelques années. Plusieurs études publiées en 2020 concernent la prise en charge de la douleur chronique. L'hypnose s'est montrée aussi efficace contre la douleur que la thérapie cognitivo-comportementale et l'éducation thérapeutique. Une étude sur les lombalgies chroniques a indiqué des dépenses de santé plus basses pour les patients recourant aux médecines complémentaires. Par ailleurs, l'hypothèse de super-répondeurs à un traitement d'acupuncture ne semble pas se confirmer. Le yoga pourrait être une approche utile dans la prévention des migraines. En ce qui concerne la prise en charge du Covid-19, l'ajout de la médecine traditionnelle chinoise pourrait diminuer certains symptômes et la durée des hospitalisations, bien que la qualité des données reste limitée.

Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial.

Hibiscus sabdariffa L. (local names: bissap, karkade) and Combretum micranthum (kinkeliba) are widely known in traditional medicines and popular beliefs for their antihypertensive effect. This study assessed the clinical effectiveness of these two plants in the galenic forms of tablet and brew (decoction) in noncomplicated hypertensive patients. In total, 219 hypertensive patients with systolic blood pressure (SBP) between 140 and 180 mmHg and/or diastolic blood pressure (DBP) between 90 and 110 mmHg, without cardiovascular or renal complications, were involved in a multicentric randomized clinical trial in Senegal comparing five treatment regimens: bissap tablets (2 × 375 mg/day), bissap brew (10 g of calyx/day), kinkeliba tablets (2 × 200 mg/day), kinkeliba brew (10 g of leaves/day), and captopril (2 × 50 mg/day) as control. During the 6 months' follow-up, a significant and equivalent decrease of SBP was observed with the herbal drug approach (-19.5 ± 16.1 mmHg, p < 0.001) and control group (-19.7 ± 16.7, p < 0.001). Regarding the galenic forms, the brews tended to be slightly more effective than tablets (reduction of SBP: -20.7 ± 15.1 mmHg vs -18.7 ± 16.7). The rates of clinically significant effectiveness (decrease in SBP ≥ 10 mmHg) were 75%, 67%, and 65% with bissap, kinkeliba, and captopril, respectively. After 6 months, target blood pressure of <140/90 mmHg was attained by 49% of patients with bissap, 51% with kinkeliba and 40% with captopril. Bissap and kinkeliba appeared, at doses utilized, to be as effective as captopril over the 6 months' follow-up. In subsequent studies, brews might be started with a lower dosage.