RESUMO
Cupping Therapy (CT) is an ancient method and currently used in the treatment of a broad range of medical conditions. Nonetheless the mechanism of action of (CT) is not fully understood. This review aimed to identify possible mechanisms of action of (CT) from modern medicine perspective and offer possible explanations of its effects. English literature in PubMed, Cochrane Library and Google Scholar was searched using key words. Only 223 articles identified, 149 records screened, and 74 articles excluded for irrelevancy. Only 75 full-text articles were assessed for eligibility, included studies in this review were 64. Six theories have been suggested to explain the effects produced by cupping therapy. Pain reduction and changes in biomechanical properties of the skin could be explained by "Pain-Gate Theory", "Diffuse Noxious Inhibitory Controls" and "Reflex zone theory". Muscle relaxation, changes in local tissue structures and increase in blood circulation might be explained by "Nitric Oxide theory". Immunological effects and hormonal adjustments might be attributed to "Activation of immune system theory". Releasing of toxins and removal of wastes and heavy metals might be explained by "Blood Detoxification Theory". These theories may overlap or work interchangeably to produce various therapeutic effects in specific ailments and diseases. Apparently, no single theory exists to explain the whole effects of cupping. Further researches are needed to support or refute the aforesaid theories, and also develop innovative conceptualizations of (CT) in future.
RESUMO
BACKGROUND: The aim of this study was to assess the level of knowledge, attitudes, and utilization of complementary and alternative medicine (CAM) of primary health care (PHC) physicians in Riyadh, Saudi Arabia. MATERIAL AND METHODS: A crosssectional study including all physicians working at PHC centers in the Riyadh region, Saudi Arabia, was carried out from the beginning of April 2010 to the end of June 2010. Using a self-administered questionnaire, 1,113 physicians answered questions regarding their socio-demographic data, and knowledge, attitudes and utilization of CAM. RESULTS: About 8% of the participants had attended a continuous medical education or a training activity. Most of them were unfamiliar with reflexology, energy healing, aromatherapy, ozone therapy, homeopathy, or chiropractic care (77.4, 71.3, 71.2, 67.2, 65.7, and 63.9%, respectively). On the other hand, most physicians felt that they could understand and feel comfortable about counseling patients about Ruqyah (spiritual healing), honey and bee products, dietary supplements, massage therapy, relaxation, herbal medicine, and cupping (40.3, 38.3, 34.9, 34.4, 25.8, 22.8, and 21.4%, respectively). More than half (51.7%) of the physicians used CAM for themselves or their family, but only 14.2% referred their patients to CAM practitioners. 85.1% of studied physicians agreed that physicians should have knowledge about CAM therapies commonly used in the region. 82.5% agreed that health authorities should have a role in regulating CAM, and 75.7% agreed that the physicians' knowledge about CAM practices leads to better patient outcome. CONCLUSION: There is a positive attitude regarding the concept of CAM, but there is a reluctance to refer or to initiate discussion with patients regarding CAM practices, which may be attributed to a lack of knowledge.
