Complementary and Alternative Medicine: An Evidence- Based Approach potx

An Affiliate of Elsevier Science 11830 Westline Industrial Drive St Louis, Missouri 63146 COMPLEMENTARY AND ALTERNATIVE MEDICINE: AN EVIDENCE-BASED APPROACH Copyright © 2003, Mosby, Inc All rights reserved 0-323-02028-3 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, PA, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: healthpermissions@elsevier.com You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com) by selecting ‘Customer Support’ and then ‘Obtaining Permissions’ NOTICE Complementary and alternative medicine is an ever-changing field Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications It is the responsibility of the licensed prescriber, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient Neither the publisher nor the author assumes any liability for any injury and/or damage to persons or property arising from this publication Previous edition copyrighted 1999 International Standard Book Number 0-323-02028-3 Publishing Director: Linda Duncan Publishing Manager: Inta Ozols Publishing Services Manager: Pat Joiner Associate Developmental Editor: Melissa Kuster Deutsch Project Manager: Gena Magouirk Designer: Mark A Oberkrom Cover Art: Harry Sieplinga Printed in U.S.A Last digit is the print number: Contributors Andrew Baron Student, Temple University, Philadelphia, Pennsylvania David A Baron, MSEd, DO Professor and Chair, Department of Psychiatry and Behavioral Science, Temple University School of Medicine, Philadelphia, Pennsylvania Iris R Bell, MD, PhD Director of Research, Complementary Medicine Program, University of Arizona School of Medicine, Tucson, Arizona Kathleen M Boozang, JD, LLM Associate Dean and Professor of Law, School of Law, Seton Hall University, Newark, New Jersey Tacey Ann Boucher, PhD Project Coordinator, Center for Addiction and Alternative Medicine Research, Minneapolis Medical Research Foundation, Minneapolis, Minnesota Cheryl Bourguignon, RN, PhD Assistant Professor and Postdoctoral Fellow, Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia Milton L Bullock, MD Director, Division of Addiction and Alternative Medicine, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota Opher Caspi, MD Faculty, Complementary Medicine Program, University of Arizona School of Medicine, Tucson, Arizona Chung-Kwang Chou, PhD Chief EME Scientist and Director, Corporate EME Research Laboratory, Motorola Florida Research Laboratories, Plantation, Florida Ann C Cotter, MD Medical Consultant, Center for Research in Complementary and Alternative Medicine, v vi Contributors Kessler Medical Rehabilitation Research and Education Corporation, West Orange, New Jersey Patricia D Culliton, MA, Dipl Ac Director, Alternative Medicine Clinic, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota Karen D’Huyvetter, ND Postdoctoral Fellow, Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia Ellen M DiNucci, MA Project Coordinator, Complementary and Alternative Medicine Program, School of Medicine, Stanford University, Palo Alto, California Daniel I Galper, PhD Postdoctoral Fellow, Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia William L Haskell, PhD Director, Complementary and Alternative Medicine Program; Deputy Director, Center for Research in Disease Prevention; Professor, School of Medicine, Stanford University, Palo Alto, California Micah Hill Research Assistant, Complementary and Alternative Medicine Program, Center for Research in Disease Prevention, Stanford University, Palo Alto, California James F Kleshinski, MD Assistant Professor of Medicine, Medical College of Ohio, Toledo, Ohio Fredi Kronenberg, PhD Director, Center for Complementary and Alternative Medicine in Women’s Health, College of Physicians and Surgeons, Columbia University, New York, New York May Loo, MD Assistant Clinical Professor, Stanford University; Director, Neurodevelopmental Program, Santa Clara County Valley Medical Center, San Jose, California Frederic M Luskin, PhD Research Associate, Center for Research in Disease Prevention, School of Medicine, Stanford University, Palo Alto, California Debra E Lyons, RN, PhD, FNF Assistant Professor and Postdoctoral Fellow, Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia Victoria Maizes, MD Faculty, Contributors Complementary Medicine Program, University of Arizona School of Medicine, Tucson, Arizona Farshad F Marvasti Research Assistant, Complementary and Alternative Medicine Program, Center for Research in Disease Prevention, Stanford University, Palo Alto, California Angele V McGrady, PhD Professor and Administrative Director, Complementary Medicine Center, Department of Psychiatry, Medical College of Ohio, Toledo, Ohio Patricia Aikins Murphy, CNM, PhD Consulting Epidemiologist, Center for Complementary and Alternative Medicine in Women’s Health, College of Physicians and Surgeons, Columbia University, New York, New York Kathryn A Newell, MA Research Coordinator, Complementary and Alternative Medicine Program, School of Medicine, Stanford University, Palo Alto, California Phuong Thi Kim Pham, PhD Program Director, National Cancer Institute, National Institutes of Health, Bethesda, Maryland Aron Primack, MD Health Scientist Administrator, Fogarty International Center, vii National Institutes of Health, Bethesda, Maryland Ru-Long Ren, MD Department of Pathology, Ball Memorial Hospital, Muncie, Indiana Samuel C Shiflett, PhD Principal Investigator and Director, Center for Health and Healing, Beth Israel Hospital, New York, New York Ann Gill Taylor, RN, EdD, FAAN Professor and Director, Center for the Study of Complementary and Alternative Therapies, University of Virginia, Charlottesville, Virginia Christine Wade Research Manager, Center for Complementary and Alternative Medicine in Women’s Health, College of Physicians and Surgeons, Columbia University, New York, New York Thanks to those who contributed to the first edition: Bruce J Diamond M Eric Gershwin Robert M Hackman Thomas L Hardie James M Horner Sangeetha Nayak James A Peightel Cherie Reeves Nancy E Schoenberger Leanna J Standish Judith S Stern Roberta C.M Wines Diane Zeitlin Preface The initial reason for writing Complementary and Alternative Medicine: An EvidenceBased Approach was the need to examine research evidence and claims purported by advocates, clinicians, and researchers of complementary and alternative medicine (CAM) regarding its effectiveness Both of us had previous experience with certain of these therapies since we had worked with American Indians who used alternative spiritual-indigenous medical approaches to health-related problems Joseph Jacobs, a Mohawk, grew up using many of these healing practices Later, we were involved at a national level establishing the first Office of Alternative Medicine (OAM) at the National Institutes of Health (NIH) The office was set up as a mandate from Congress to scientifically evaluate the claims made by the CAM community regarding treatment efficacy and safety We have attempted to be sensitive to and aware of the continuing debate over the need to study CAM An early concern voiced by conventionally trained physicians, health providers, and scientists that its evaluation was a waste of time, partially because CAM had no scientific basis and partially because it simply was not useful, and in some cases, safety concerns could be raised, is still heard today Our first edition evaluated many CAM therapies used for a variety of medical conditions While there was no definitive or consensual finding regarding treatment efficacy, this should not be surprising given the paucity of research effort and financial expenditure for CAM evaluation Therapies such as acupuncture, massage, and “psychological” (biofeedback, meditation-relaxation) have been increasingly used by consumers and also studied and evaluated, and a pattern of valid and reliable outcomes, under certain conditions, appears to be evolving Our second edition provides updated information on CAM since the late 1990s, as well as several new areas that are both important and relevant to the practice of CAM Our goals for this second edition remain unchanged from our earlier work We want the book to contain the most recent and updated material concerning CAM and to be able to serve as a reference for physicians, health care providers, and scientists We recognize that this is a formidable task because of the huge and not very well-defined areas of CAM It is not possible to cover every study or therapy, but we tried to establish some general guidelines within which therapies and medical ix x Preface conditions were evaluated based on reported usage, recent demographic evaluations, and study quality We hope by providing an evidence base for CAM that we continue to contribute to a database that allows the consumer, clinical scientist, and practicing healthcare provider to make knowledgeable decisions about CAM usage That knowledge about healthcare practices regarding their integration with conventional medicine, where appropriate, will benefit patients and make available the safest and highest quality of medicine ORGANIZATION OF THE BOOK We, as editors, have sought to allow the various chapter contributors the freedom to review and discuss those therapies that in their opinion merit the most focus We have encouraged the use of as many databases as possible pursuant to establishing a firm evidence base Besides using the federal Medline NIH Database, each author has supplemented their chapters differently One major addition is our attempt to allow for more discussion(s) regarding the quality of the studies with less emphasis on simple quantity We have also attempted in Appendices B and C to provide readers with more information about where clinical and research data regarding CAM exist With such a quickly and continuously growing field, however, today’s information about CAM is almost outdated by tomorrow Complementary and Alternative Medicine: An Evidenced-Based Approach is organized around three major themes The first part, Basic Foundations (Chapters and 2), evaluates what is known about CAM focusing on definitional, usage, and research (clinical and preclinical) strategies; positioning of evidence-based medicine; and education/training During the late 1990s, the movement by the Cochrane group to provide more systematic reviews for CAM therapies is an encouraging sign to place more emphasis on stronger research methodology Although there are clear and major differences of opinion regarding the usefulness of certain research methodologies, by allowing for closer scrutiny of many different types of designs we suggest that a more relevant clinical and scientific outcome may evolve The debate concerning the “placebo response” is a noteworthy example of the many research and clinical questions reviewed in this text Its place in the healing process as well as its “control” attributes cannot and should not be ignored A greater knowledge base concerning the potentially strong influence of the mind\brain in many healthcare issues may be an outgrowth of the “placebo” study and debate The second and largest part, Clinical Research Outcomes: Use of Complementary and Alternative Therapies in General Medicine, evaluates and reviews clinical research In Chapter 3, CAM’s role in treating asthma and allergies is presented carefully, reviewing the evidence and allowing readers to form their own conclusions regarding CAM contributions Chapter reviews and updates what has been done in the area of cancer Although there is no major change in the reported efficacy of CAM in the treatment of cancer, potentially useful approaches may be on the horizon Noteworthy is the American Cancer Society’s recent contribution of common herbal use with cancer Chapter reviews atherosclerotic vascular disease, focusing on the importance of both prevention and the integration of CAM to maximize benefit Chapter has more Preface xi information on the use of herbs with diabetes mellitus Quality of life remains an important issue Chapter reviews CAM therapies in the treatment of neurological conditions with an appropriate focus on rehabilitation issues Chapter evaluates CAM in the field of psychiatry Importantly, the continued tracking and review of the use of St John’s wort for the treatment of mild to moderate depression and the issue of safety with kava-kava for anxiety management is featured Chapter discusses the use of CAM in the treatment of alcohol and chemical dependency While many therapies have at times produced “positive findings,” there still remains a challenge in producing consistency and replicable results The complexity of many factors that are associated with substance abuse and its treatment needs much more evaluation and clarification in all treatment protocols Chapter 10 directs attention to the ubiquitous area of pain control by the use of CAM methods Recent studies that have evaluated manipulation procedures or the use of massage points to some useful findings Also encouraging is the work of acupuncture in the treatment of fibromyalgia Chapters 11 to 13 feature populations that increasingly constitute significant numbers of CAM consumers: children, women, and the elderly The uniqueness of these populations and their importance in more accurately framing research questions around specific targeted areas needs strong emphasis Of special concern are attention-deficit disorder as a possible medically overtreated health problem, the nausea and vomiting associated with pregnancy, and Alzheimer’s and osteoarthritis and the important realm of quality-of-life issues In the final part, Future Directions and Goals for Complementary and Alternative Medicine, a new chapter, Legal and Ethical Issues (Chapter 14), directs attention to the impact and interaction(s) that must occur between CAM and the legal field, as well as updating and reviewing the important issues of accreditation and licensing of CAM providers This is extremely relevant to the validation of CAM as being clinically trustworthy and safe A second new chapter, Integration of Clinical Practice and Medical Training with Complementary and Alternative and EvidenceBased Medicine (Chapter 15), features the place for CAM in the context of integrative medicine and its part for healthcare and society While one aspect of an evidence-based medicine may arguably be the inclusion of science and experimentally driven procedures such as statistics, the individual patient should not be “left out of the equation.” Importantly, this concept and evidence-based medicine as one part of CAM should be directed at medical students at various levels or stages of training Chapter 16 provides a review of the importance and needs of the consumer in a driven business market At the federal level, regulation of CAM for both consumer protection and validation of usefulness and safety is necessary A final summary (Chapter 17) puts forward potential emerging CAM therapies that should be tracked and watched for future outcomes A list of goals that are attainable and relevant to the development of CAM and evidence-based medicine is provided Note: John Spencer and Joseph Jacobs are writing as individuals, and as such anything contained within does not reflect any present or past policy of the NIH or any other organization/association they have been or are currently affiliated with Acknowledgments Many people have provided varying degrees of assistance in the writing of this second edition In addition to those we listed in the first edition, many of whom were helpful in this edition, we would like to acknowledge Karen Keating and Fern Ingber for their help with Chapters and 16 respectively We are especially grateful to Jennifer Watrous, Melissa Kuster Deutsch, Gena Magouirk, Kellie White, and Inta Ozols at Elsevier Science We, as editors, would like to especially thank the following individuals for reviewing chapters from the first and second editions of Complementary and Alternative Medicine: An Evidenced Based Approach: Marjorie Bowman Laurel Archer Copp Richard Cumberlin Sadja Greenwood Robert Michael David Scheim Neil Sonenklar William Stuart Jackie Wootton John W Spencer, PhD Joseph J Jacobs, MD, MBA Fall, 2002 xii CHAPTER Essential Issues in Complementary and Alternative Medicine JOHN W SPENCER T he debate between proponents and critics of complementary and alternative medicine (CAM) continues to renew both old and new arguments and biases at the start of the twenty-first century The opinions of health providers, consumers, and researchers remain divided on whether this “unproven form of medicine” can be or ever will be demonstrated as being cost-effective, accessible, and most importantly, medically useful and safe Even writing about CAM, especially when using terminology not familiar to the general public, can be fraught with difficulties and complexities New sensitivities in medical language need to evolve as CAM becomes better understood through its study, evaluation, and ultimate acceptance or rejection That is, definitions and descriptions of CAM should remain flexible as more information about this evolving field becomes available This chapter discusses six areas that are important in shaping the best “descriptors” of CAM: definitional, historical antecedents, usage-demographic factors, clinical/research methodologies, evidence-based issues, and training/education These areas are not mutually exclusive but rather interact and are mutually influential Chapter 16 focuses on tangential but important areas of consumer involvement, the CAM market, and federal/state regulations Definitional Considerations Complementary or alternative medicine can be defined as a single or group of potentially classifiable procedures that are proposed to either substitute for or add to more conventional medical practices in the diagnosis/treatment or prevention areas of health A single definition of CAM cannot exist, however, without considering many cofactors, and even these can be problematic For example, consider the following: CHAPTER 1: Essential Issues in Complementary and Alternative Medicine COMPLEXITY OF FIELD The field of CAM is multifaceted and multilayered in terms of its components Many disparate therapies help delineate CAM’s scope, including acupuncture, homeopathy, herbal therapies, hypnosis, and systems such as naturopathy The focus, theoretic basis, and history of many therapies allow them to be grouped by a taxonomy or classification that becomes one part of their defining dimension.54 For example, CAM can be part of a larger category of procedures, such as chiropractic, that is nested within a licensed, regulated, and professionally independent system, whereas CAM therapies of guided imagery and botanicals are placed in “mind-body” and “popular-health reform” categories, respectively (See Appendix A and Suggested Readings, especially Novey, 2000.) The assumption, however, that all of CAM is some type of a vague or “weird” form of health practice that is generally excluded from more conventional medicine is simply not true Physical therapy, massage, biofeedback, hypnosis, and chiropractic procedures form the basis of many common health therapies that are ancillary to medicine as practiced by the vast majority of physicians who generally emphasize the use of pharmaceuticals as first line treatment It is true, however, that CAM therapies are not at present partially or fully adopted as “standard treatments” by conventional medicine SCIENTIFIC CREDIBILITY Any description of CAM should acknowledge that CAM has not been proven to be either completely safe or useful for many health-related areas Attempts to show convincing treatment efficacy through clinical research have failed in part because of poor scientific quality and insufficient evidence (see later sections in this chapter and the described evidence base in subsequent chapters including strategies for integration of CAM with conventional medicine described in Chapter 14) MEANINGFUL TERMINOLOGY The actual terms alternative and complementary need to be closely evaluated because their use in the clinical setting relative to conventional treatments can become an important distinction Words such as “alternative,” “untested,” “unproven,” “unconventional,” and “unorthodox” generally include medical or health therapies that become replacement or substitute (alternative) therapies for orthodox treatments An example is shark cartilage used in place of more conventional therapy for cancer treatments (radiation or chemotherapy) Complementary therapies include those treatments that are used with and in addition to conventional treatments, such as treatment of hypertension or diabetes by the use of conventional medication and complementary biofeedback or relaxation procedures Thus biofeedback complements the biologic effects of blood pressure medication, possibly allowing for lower doses and minimizing drug side effects while optimizing treatment effects 618 Index Herbal medicines—cont’d cancer treatment with Ayurvedic, 111 common types in, 117-122, 124t-126t efficacy of, 137 Hoxsey tonic in, 113 integrative medicine and, 520, 521, 529 for cocaine addiction, 297, 297t for colic, 430 definition of, 576 for depression, 249 for diabetes mellitus, 179-184 for diarrhea, 429 drug interactions with, 95, 98 efficacy studies for, 565-566 FDA regulation of, 553, 557 for hot flashes, 462-463 for insomnia, 264, 265 for multiple sclerosis, 221 national policy for, 562 for nausea and vomiting in pregnancy, 471 for neurologic disorders, 198t, 202-204, 227 for pain efficacy of, 396 fibromyalgia, 392t headache, 363, 366t-367t low back, 347t, 354 trauma-related, 331, 333t-334t vascular, 396, 397t pilot studies of, 10t preclinical studies of, 62 for psychiatric disorders, 269, 270, 270t, 271 for psychotic disorders, 259-260 quality standards for, 62, 81, 83, 117, 557 research priorities for, 568t resources for, 590-591 for rheumatoid arthritis, 354, 355t-358t for skin rashes, 435 for stroke, 212 toxicity or adverse effects of, 98t, 122-123 Ayurvedic herbs and, 111 cancer remedies and, 119, 124t-126t reporting, 558, 559 reviews of, 554t-555t usage of assessment of, 98, 505-506 children and, 410, 418 elderly persons and, 482 expenditures for, 546, 547t history of, surveys on, 11 women and, 459-461, 462 WHO evaluation of, 551 Heroin addiction, CAM therapies for, 285t, 286t, 288-289, 290t Herpes zoster, pain treatment for, 374t Hertz, Heinrich, 53 HIV/AIDS acupuncture for insomnia in, 264 definitions of, 600, 602 pain treatment for, 373t, 375t Holistic care CAM model for, 17 evidence-based medicine and, 526 goals for, 570 integrative medicine and, 517, 518, 529, 534, 535-536 managed care and, 549 Holy basil leaves for diabetes mellitus, 180t, 183 Homeopathic Pharmacopeia of the United States, 557 Homeopathy for ADHD, 439 for allergies, 86-87, 87t, 422, 568t for anxiety, 256 for asthma, 73t, 80-81, 82t, 83, 425-426 for cancer, 134 clinical integration of, 561 definition of, 576 for depression, 250, 256 for diabetes mellitus, 184-185 for diarrhea, 428-429 efficacy studies of, 565-566 FDA regulation of, 557-558 history and philosophy of, 7, 80-81 for hot flashes, 462 immunization practices in, 411t, 414-415 licensure for, 512-513 national policy for, 562 for neurologic disorders, 196t, 210-211, 215-216 for otitis media, 420-421 for pain headache, 367t-368t, 372 rheumatoid arthritis, 358t trauma-related, 331, 334t-335t pilot studies of, 10t preclinical studies of, 63 safety of, 556t, 558 for skin rashes, 435 for upper respiratory infections, 418 usage of children and, 410, 411t expenditures for, 547t surveys on, 11, 12 women and, 459 Homocysteine, AVD and, 166 Hopefulness, therapeutic role of, 251 Hops for anxiety or stress, 269 Hormone replacement therapy for Alzheimer’s disease, 484, 488 Hormone replacement therapy—cont’d for hot flashes, 459, 461-462 melatonin use in, 205 for osteoarthritis, 492t, 493 Horseback riding, therapeutic, 197t, 582 Hospital Anxiety and Depression scale, 253 Hospitals, CAM usage in, 548, 549 Hot flashes acupuncture for, 110 CAM therapies for, 461-466, 476 dong quai for, 601 hormone therapy for, 459 The House of Lords Report, 562 Hoxsey herbal treatment for cancer, 113 Human evaluation studies in preclinical research, 61-62, 63 Human immunodeficiency virus See HIV/AIDS Human models in preclinical research, 42, 61-62, 63 Humanistic care See Holistic care Hydergine, 198t, 577 Hydrastis canadensis for cancer, 125t Hydrazine sulfate for cancer, 130, 577 Hydrotherapy for arthritis, 359t 5-Hydroxytryptophan for depression, 242-243, 243t, 244 Hyperbaric oxygen therapy for cancer, 134 definition of, 577 for neurologic disorders, 198t, 214, 216, 220 resources for, 592 Hyperemesis gravidarum, CAM therapies for, 468, 470 Hypericum perforatum See St John’s wort Hypertension cognitive-behavioral therapies for, 160-161, 161f herbal medicines for, 167 mind-body therapies for, 64, 157-158, 158f, 159, 160, 211 spiritual care for, 162 Hyperthermia for cancer current status and future of, 59-61 definition of, 577 mechanism of action in, 52, 129 preclinical studies of animal studies in, 57-59 clinical trials in, 59, 60f heat applicator development in, 56-57, 57f heating methods in, 54-56 history of, 52-53 issues in, 53-54 Index Hypnosis for ADHD, 437 for alcoholism, 294t, 295 for allergies, 422 for asthma, 424 children and, 411, 411t definition of, 578 for diabetes mellitus, 185t, 186 for enuresis, 431 for nausea and vomiting, 136, 471 for neurologic disorders, 197t, 211, 216, 219, 226 for nicotine addiction, 297-298 for pain cancer-related, 135, 378, 379t-380t dental, 372, 376t-377t efficacy of, 396 fibromyalgia, 384 headache, 363 postoperative and procedural, 314, 320t-326t rheumatoid arthritis, 359t360t temporomandibular joint, 384, 388t-389t trauma-related, 335t-336t, 339 pilot studies of, 10t for psychotic disorders, 258 research priorities for, 568t for skin rashes, 435 surveys on usage of, 11 Hypnotic induction profile test, 602 Hypoglycemia, 173 Hypoglycemic agents, oral actions of, 174 herbal medicines used as, 179, 180t, 181b Hypothermia treatment for stroke, 214 Hypothesis testing, 17 Hypotonic hyporesponsive episodes, vaccines and, 414 Hysterectomy, 459 I Ibogaine for chemical dependency, 300 Ilex plants, toxicity of, 98t Illness See Disease Imagery See Guided imagery Imipramine for enuresis, 431 Immune response acupuncture and, 85-86, 417, 425, 475 in asthma, 72, 78, 423 in atopic eczema, 84 breast-feeding and, 417 herbal medicines and, 84, 121, 124t, 260, 475-476 immunizations and, 413, 414 medicinal mushrooms and, 521 melatonin and, 132 Immune response—cont’d mind-body therapies and, 22-23, 127, 475, 521 in otitis media, 418-420 Immunizations, controversy over, 411-415, 411t See also Vaccines Immunoaugmentative therapy for cancer, 127, 577 Immunoglobulin A acupuncture and, 85-86, 425 breast-feeding and, 417 definition of, 602 Immunoglobulin E acupuncture and, 85, 86 asthma and, 78 Chinese herbs and, 84 Immunoglobulin G, 602 Immunotherapy for cancer, 127, 132, 134 In vitro/in vivo assays, 41, 602 India, traditional medicine in See Ayurvedic medicine Indomethacin, antioxidants and, 76 Infants asthma in, 423 atopic dermatitis in, 434 breast-fed, otitis media and, 420 CAM therapies for for colic, 429-430 for diarrhea, 427, 428-429 for upper respiratory infections, 415, 416-417, 418 usage of, 409 vaccination of, 413-414 Infertility, phytoestrogens and, 473 Inflammation airway, asthma and, 72-73, 423, 425 atopic eczema and, 84 Inflammatory bowel disease, CAM usage for, 412b Influenza virus, 415 Information, consumer access to, 544-545, 546, 561-562, 570 See also Evidence Informed consent children and, 440 for clinical trials, 19, 20 legal requirements for, 507, 509-512 process checklist for, 598-599 Injuries See Spinal cord injury; Traumatic brain injury; Traumatic injuries Inositol hexaphosphate, cancer and, 107 Insomnia CAM therapies for, 263-266, 270, 270t clinical significance of, 237 electrosleep for, 256 etiology and types of, 262-263 619 Insomnia—cont’d orthomolecular therapy for, 244 Instinctotherapy for cancer, 112 Institute of Personality and Ability Testing anxiety scale, 254 Insulin CAM adjuncts to, 175-176 chromium and, 177 diabetes management with, 173, 174 polypeptide-p, 180t, 184 Insurance plans, reimbursement by, 4, 504, 548-551 Integrative medicine See also Complementary and alternative medicine; Conventional medicine clinical practice of case study for, 518-523 information and evidence in, 523-533 education program for, 533-538 goals for, 538 philosophy of, 517-518, 533-534, 559, 570 Intercessory prayer, 162, 186, 580 Interferon, 78, 106, 416 Interleukins in cancer therapy, 110, 127, 132 Chinese herbs and, 84 Intermittent claudication CAM therapies for, 157, 188, 396, 397t definition of, 602 International Union against Cancer, 94 Interstitial hyperthermia, 55-56 Intracavitary hyperthermia, 55, 57-59, 60f Investigational New Drug applications, 552 Ion diffusion in electrochemical treatment, 49-50 Ipecacuanha for asthma, 80 Iridology, 602 Iron deficiency, ADHD and, 438 Iscador for cancer, 109t, 121-122, 475 Ischemic reoxygenation, herbal medicines and, 202, 203-204, 210, 212 Isocyanates, 602 Isoflavones in black cohosh, 462 cancer prevention and, 107, 473 definition of, 602 for hot flashes, 462-463, 464 Isotretinoin for oral leukoplakia, 106 Ivy gourd for diabetes mellitus, 179, 180t 620 Index J Japanese herbs for asthma, 79, 82t Jenkins Activity Survey, 267, 602-603 Jimson weed for asthma, 74, 79-80 toxicity of, 98t Jin bu huan, toxicity of, 123 Jin shin jyutsu, 577 Johns Hopkins University, 101 Joint replacement surgeries, 490, 491 Journals, CAM, 9, 26, 99, 587-590 Juicing for cancer, 115t Justice, concept of, 507 K Kampo formulations for anxiety and depression, 249 for asthma, 79 definition of, 603 for stroke, 212 Kava for anxiety, 255-256, 269, 568t for stroke, 212 toxicity of, 62, 98t, 559, 567 Kelley diet for cancer, 113 Keyhole limpet hemocyanin for cancer, 109t Khat, toxicity of, 98t Kinesiology, applied, 572 Knowledge base bridging gaps in, 526-527 development of, 527-528 Kombucha for cancer, 115t Kousmine diet for cancer, 112 Krebs, Ernest, Jr., 131 Kuhn’s theory of paradigm shift, 533 Kushi, Michio, 112 L Lactobacillus acidophilus for cancer, 114t Lactones in kava, 255-256 Lacunar stroke, 206 Laetrile for cancer, 112, 131 definition of, 577 efficacy studies of, 40 toxicity of, 98t Lapachol for cancer, 125t Laser acupuncture, 201 for ADHD, 439, 439f, 440f for carpal tunnel syndrome, 344t children and, 410, 411t for enuresis, 433 for stroke, 209 Lawsonia alba, toxicity of, 98t Lay standard for informed consent, 510 L-dopa, 223, 224 Leadership in integrative medicine curriculum, 536 Lectins, cytotoxic effects of, 121-122 Ledebouriella seseloides for asthma, 79 Legal issues for CAM integration or referrals, 508-514, 566 for new drugs and devices, 41 for standard of care, 505-506 Legal Status of Traditional Medicine and Complementary/ Alternative Medicine: A Worldwide Review (WHO), 551 Legumes, phytoestrogens in, 463-464 See also Soybeans Leukemia, 105, 109t, 380t Leukoplakia, oral, 105, 106, 109t Leukotriene receptor antagonists, 424 Leukotrienes, 76-77, 603 Li Shi-Zhen, Licensure laws, 7, 508, 512-513 Licorice, 79, 98t, 122 Lifestyle Alzheimer’s disease and, 483-484 AVD risk and, 153, 155, 160, 167 cancer prevention and, 101-102 Lifestyle change programs, 176-177, 497 Lifestyle Heart program, Ornish’s, 550, 559 Lifestyle practices in integrative medicine curriculum, 534 Light therapy for alcoholism, 295, 295t definition of, 578 for nicotine addiction, 298, 299t Lignans, 463, 464, 602 Likert Self-Report clinical studies using, 255, 256, 268 definition of, 603 Linoleic acid, cancer and, 103, 474 Linseed oil, 166, 261 Lipid filtration hypothesis in AVD, 154 Literature review See Systematic reviews Liver cancer antineoplastons for, 110 diet and, 102 electrochemical treatment for, 43 herbal medicines for, 118, 120-121 Liver toxicity See Hepatotoxicity Local hyperthermia, 53, 54-56 Locus of control, self-care and, 175, 603 Lorig, Kate, 495 Low back problems, prevalence of, 339 See also Back pain Low-calorie diets for diabetes, 176-177 Low-density lipoprotein cholesterol AVD risk and, 154, 155 definition of, 603 reduction of antioxidants for, 165-166, 212 herbal products for, 167 melatonin and, 213 plant-based diet for, 163, 164 Low-energy emission therapy for insomnia, 265 Low-fat diets, 164, 222, 464 LSD See also Hallucinogen therapy treatment for abuse of, 282, 299 treatment of addiction with, 300, 576 Lung cancer Ayurvedic medicine for, 111 diet and prevention of, 102, 105-107 electrochemical treatment for, 43, 44, 52 herbal medicines for, 118, 121 hydrazine sulfate for, 130 integrative treatment of, 519-523, 529-532 palliative care for, 135-136, 382t shark/bovine cartilage for, 133 Lycopene for cancer, 115t Lymphoma, CAM therapies for, 94, 379t-380t M MA-631 for AVD, 167 Ma huang adverse effects of, 123, 167, 506, 555t for asthma, 78, 82t Macrobiotic diets, 10t, 112, 464 Macrophages in AVD, 154 Magnesium for ADHD, 411t, 438 for asthma, 78, 82t for diabetes mellitus, 177 for headache, 363, 366t-367t Magnetic therapy See also Electromagnetic therapies definition of, 578 for pain, 327t, 331, 348t, 394t research priorities for, 568t Magnolia for asthma, 78 Maharishi (MAK) compounds for cancer, 111 Maimonides, Moses, 74 Maitake mushroom for cancer, 115t, 521 Index Major depressive disorder See also Depression conventional treatment of, 241 definition of, 239 prevalence and cost of, 237, 240 St John’s wort and, 506 Malondialdehyde, cancer and, 105 Malpractice, 508, 511 “Mamane” for asthma, 79 Managed care, 504, 548-551 Mandrake, 80, 117 Manganese-superoxide dismutase, asthma and, 77 Mania See also Bipolar disorder symptoms of, 258 treatment of, 241, 259, 261 Manipulation See also Chiropractic; Massage therapy adverse effects of, 111, 201, 555t, 558 manual, definition of, 578 for neurologic disorders, 200-201, 211, 219, 226 for pain fibromyalgia, 394t-395t headache, 368t-370t, 372 musculoskeletal, 339, 343t, 348t-351t, 354 trauma-related, 336t preclinical studies of, 63 research priorities for, 568t surveys on usage of, 11-12, 13 Margosa oil, toxicity of, 98t Marijuana, 125t, 281 Market for CAM managed care and, 548-551 retail products in, 546-548, 548t Massage therapy for Alzheimer’s disease, 489 for anxiety, 252-253 for asthma, 426 for atopic eczema, 435-436 for burns, 336t-337t, 339 for cancer, 128 clinical integration of, 560 for colic, 411t, 430 definition of, 578 licensure for, 508 for neurologic disorders, 196t, 211, 217, 218-219, 226 for nicotine addiction, 298, 299t for osteoarthritis, 492t, 496 for pain cancer-related, 378, 381t-382t headache, 368t, 372 low back, 352t, 354 postoperative and procedural, 327t-328t, 331 pilot studies of, 10t preclinical studies of, 63 research priorities for, 568t surveys on usage of, 12 Materia medica, Chinese, Materiality, standard of, for informed consent, 510 Measles, incidence of, 412 Measles-mumps-rubella vaccine, 414 Meat, consumption of cancer and, 103, 104, 108, 109t multiple sclerosis and, 222 Mechanism of action studies for electrochemical treatment 49-50, 51f knowledge base for, 527 Median lethal dose, 42 Medical boards, 512-513 Medical devices expenditures for, 546, 547t regulations for development of, 41, 50, 52, 552 Medical education See Education, medical Medical Education in the United States and Canada (Flexner), 7, 602 Medical history, integrative approach for assessing, 519-520 Medical schools biomedical focus in, CAM education and training in, 29-34, 570 integrative medicine program in, 533-538 national CAM policy for, 561, 562 paradigm shift in, 533, 534 Medications for ADHD, 436 for alcohol and chemical dependency, 281-282, 300 for Alzheimer’s disease, 484 for asthma, 81, 423-424 cancer (See Chemotherapy) children and, 441 in Chinese materia medica, clinical trials of, placebo use in, 21-22 development of, preclinical studies for, 99-100 FDA regulation of, 552 herbal interactions with, 95, 98 homeopathic, 557 mood disturbances from, 239, 240 for neurologic disorders, 198t-199t, 204-205 new, preclinical studies for, 41-42 for osteoarthritis, 491 plant products used in, 117, 202 pregnancy and, 466 for upper respiratory infections, 416 621 Medicine See also Conventional medicine biomedical model in, 7, 17 holism vs reductionism in, 517, 529, 534 paradigm shift in, 543 science vs art in, 523-524, 533-534, 538 Meditation for alcoholism, 294t, 295 for anxiety, 253-255 for AVD, 157-158, 158f for cancer, 127, 128 for chemical dependency, 290t, 297, 297t, 298, 299t definition of, 578 for neurologic disorders, 197t, 211 preclinical studies of, 63-65 for stress, 267-268 Mediterranean diet, 164, 578 MEDLARS (database), 238 MEDLINE CAM resources in, 26, 27, 523, 595-596 retrieving data from, 530 MedWatch program, 558 Megavitamins for ADHD, 437 Melanoma See also Skin cancer herbal medicines for, 120, 122, 124t immunotherapy for, 127 sesame/safflower oil for, 109t Melatonin endogenous cancer and, 131-132 meditation and, 128 multiple sclerosis and, 222 music therapy and, 487-488 Parkinson’s disease and, 224 role of, 205 stroke and, 213 supplemental for cancer, 132, 137 for epilepsy, 225 for insomnia, 266 for neurologic disorders, 198t safety of, 205 for whiplash, 333t Melatonin inhibitory factor 1, Parkinson’s disease and, 224 Memories, healing response and, 22 Memory loss in Alzheimer’s disease, 483 Ginkgo biloba for, 203-204, 203f, 485 Men AVD in, 155 CAM usage by, 459 depression in, 240 stress in, 267 622 Index Menopause, health problems during, 459 See also Hot flashes Mental health disorders See Psychiatric disorders MeSH terms, 530, 603 Mesmer, Anton, Meta-analysis criteria for, 25-26 data retrieval for, 26-27, 530-531 definition of, 603 quality of, 523, 567 “Metabolic” diets for cancer, 112 Metaplasia, 603 Methadone, 281, 300 Methionine, cancer and, 107 Methotrexate, 106 Methylphenidate, 436, 438-439 Microwave coupling in hyperthermia, 54, 55-57 Migraine acupuncture for, 364t-365t CAM therapies for, 363, 372 herbal therapy and supplements for, 366t-367t homeopathy for, 367t-368t manipulation for, 368t-370t relaxation techniques for, 370t, 371t Milk thistle for cancer, 125t for diabetes mellitus, 180t, 183 Mind-body therapies See also Guided imagery; Hypnosis; Meditation; Relaxation techniques; Yoga for AVD, 157-163 for cancer, 94, 127-128, 137, 474-475, 522 culture and acceptance of, 175 definition of, 578 for diabetes mellitus, 185-189, 185t healing potential of, 22-23 for neurologic disorders, 197t, 222-223 for osteoarthritis, 492t, 495-496 preclinical studies of, 63-65 women’s health and, 461 Minerals for ADHD, 437, 438 for alcoholism, 292, 293 cancer and, 107, 108, 521 FDA regulation of, 553 Minority approach in standard of care, 509 Mistletoe for cancer, 109t, 121-122, 475 MMR vaccine, 414 Moerman diet for cancer, 112 Moisture alarms for enuresis, 431 Molybdenum, pancreatic cancer and, 108 Momordica charantia for diabetes mellitus, 180t, 184 Monoamine oxidase inhibitors, 243, 245, 245t Monocytes in AVD, 154 Mood disorders See Bipolar disorder; Depression Moore v Baker, 510-511 Morbid Anxiety Inventory, 255 Morinda citrifolia for cancer, 115t Morphine addiction, acupuncture for, 284t-285t, 289 Morphologic studies for electrochemical treatment, 50, 51f Mortality rates for asthma, 70, 422 for AVD, 153, 155, 162, 163, 164 for breast cancer, 472 for infectious diarrhea, 427, 428 for stroke, 206 for substance abuse, 279 MOS 36 Short Form Health Survey, 469 Motion sickness, 467 Movement therapy for psychotic disorders, 259 See also Dance therapy Moxibustion, 10t, 201, 572 Mucositis, CAM therapies for, 136 Multiinfarct dementia, CAM therapies for, 485, 486 Multimodal Treatment Study of ADHD (NIMH), 436 Multiple sclerosis CAM therapies for, 196t-199t, 202, 221-223 pathophysiology of, 220-221 Multivariate analysis, 24, 25f Muscle energy technique, 579 Muscle relaxation, progressive See Progressive muscle relaxation Musculoskeletal pain, CAM therapies for, 196t, 339, 340t-353t, 354 Mushrooms, medicinal See also Fungi for cancer, 115t, 117-118, 521 toxicity of, 98t, 555t Music therapy for Alzheimer’s disease, 486-488 for anxiety, 252 for AVD, 159 in cancer treatment, 129, 136 definition of, 579 for neurologic disorders, 197t for pain dental, 372, 377t fibromyalgia, 395t postoperative and procedural, 314, 328t-330t, 331 trauma-related, 337t, 339 Music therapy—cont’d for Parkinson’s disease, 223 pilot study of, 10t Myocardial infarction CAM therapies for, 162-163, 164, 165 pathophysiology of, 154 Myoelectric biofeedback See Electromyographic biofeedback N Naloxone, placebo response and, 21 Naltrexone, 281 National Acupuncture Detoxification Association, 283, 286, 603 National Arthritis Foundation, 495 National Cancer Institute Best Case Series Program of, 100 herbal repository of, 117 Laetrile study by, 40 pain treatment recommendations of, 378 research sponsorship by, 101, 107, 108, 111, 129 National Center for Complementary and Alternative Medicine See also Office of Alternative Medicine CAM integration and role of, 561, 562, 567, 570 placebo conference of, 22 research funding by, for acupuncture, 553 for cancer, 101, 102, 134 for preclinical studies, 65 for St John’s wort, 248 resources available from, 301, 561, 586, 596 National Center for Health Statistics, 313 National Formulary symbol, 557 National Health and Nutrition Examination Surveys (NHANES), 76, 77, 603 National Institute of Arthritis and Musculoskeletal and Skin Diseases, 493, 497 National Institute of Child Health and Human Development, 413 National Institute of Mental Health, 248 National Institutes of Health See also specific Office acupuncture consensus statement by, 17-18, 110, 178, 298, 396, 493, 553 on behavioral and relaxation therapies, 263, 363 CAM curriculum development by, 537 Index National Institutes of Health—cont’d collaborative efforts of, 570 research funding by, 8-9, 10t, 65, 101 resources available from, 586, 587, 595-596 women’s health agenda of, 458 National Institutes of Mental Health, 436 National Library of Medicine, 26, 238, 595-596 Native American therapies, 462, 579 Natural killer cells, potentiation of, 521, 522 Naturopathy See also Herbal medicines children and safety of, 410 definition of, 579 for enuresis, 434 licensure for, 508 for otitis media, 421 Nausea and vomiting See under Chemotherapy; Pregnancy Neck pain acupuncture for, 340t-341t electrical stimulation for, 346t manipulation for, 339, 349t, 350t, 354 Negligence, 509, 511-512 Nei Guan point definition of, 603 in treatment of nausea and vomiting, 466-467, 468t, 471-472 Neonates See Infants Nerve tissue demyelination of, 220, 221 regeneration of, acupuncture and, 217 Neuroelectric therapy See also Transcranial electrostimulation; Transcutaneous electrical nerve stimulation for alcoholism, 294t, 295 for anxiety, 256 for cocaine addiction, 297, 297t definition of, 579 for insomnia, 264-265 Neurogenic bladder dysfunction, 432 Neuroleptic medications for ADHD, 436 for Alzheimer’s disease, 484 herbal therapy combined with, 260 Neurologic disorders acupuncture for, 196t, 207-210, 217-218, 221, 223, 225 alternative medical systems for, 196t, 200 Neurologic disorders—cont’d brain stimulation for, 224 CAM therapies for, categories of, 195-206 chelation therapy for, 213-214 chiropractic and manipulation for, 196t, 200-201, 211, 219 diet and nutrition for, 212-213, 221-222 electromagnetic therapies for, 199t, 205-206, 226-227 emotional impact of, 195, 226 energy healing for, 197t, 212, 219-220 Ginkgo biloba for, 198t, 210, 215 herbal medicines for, 198t, 202-204, 212, 221 homeopathy for, 196t, 210-211, 215-216 hyperbaric oxygen for, 198t, 214, 216, 220 hypnosis for, 197t, 211, 216, 219 massage for, 196t, 211, 217, 218-219 meditation for, 197t, 211 melatonin and, 198t, 213, 222, 224, 225 mind-body therapies for, 197t, 222-223 music therapy for, 197t, 223 nonconventional bodywork for, 196t-197t, 200-202 pharmacologic and biologic therapies for, 198t, 204-205 psychologic treatment for, 226 resources for, 593 surgical intervention for, 226 yoga for, 197t, 225 Neurologic therapy for opiate addiction, 290t Neuropathic pain, CAM therapies for, 372, 373t-375t Neuropathy, diabetic acupuncture for, 176, 373t electrical stimulation for, 374t-375t Neuroscience chemical dependency theories in, 279-280 depression and advances in, 241 Neurotransmitters acupuncture and, 61 addiction and, 280, 281, 293 in Alzheimer’s disease, 483 melatonin and, 205 mind-body therapies and, 64, 128, 487-488 Neutrophils, asthma and, 72 Newcastle disease virus, 134, 579-580 Newtonian paradigm shift, 6-7 623 Niacin for osteoarthritis, 493 psychotic disorders and, 261 toxicity from, 123 Nicotinamide for diabetes mellitus, 177 Nicotine addiction See also Smoking CAM therapies for, 297-298, 299t pharmacologic treatment of, 282 theories on, 279 Nimodipine, 485 Nitric oxide, AVD and, 166 Nocebo, 21 No-effect dose, 42 N-of-1 design, 20, 603 Non-blind trials, 42 Noni plant for cancer, 115t Nonsteroidal antiinflammatory agents for Alzheimer’s disease, 484 asthma and, 71 for cancer, 109t for osteoarthritis, 491, 492 Non-treatment See Placebo Nopal for diabetes mellitus, 180t, 184 Nordenström, B.E.W., 43, 44, 47 Norepinephrine alcoholism and, 293 mind-body therapies and, 64, 487-488 North American herbs for asthma, 80, 82t Nortriptyline for nicotine addiction, 282 Nottingham Health Profile, 207, 209, 603 Nuisance variables, controlling, 18, 19 The Nuprin Pain Report, 313 Nurses’ Observation Scale for Inpatient Evaluation, 260, 603 Nutrition Labeling and Education Act (1990), 553 Nutrition therapy See also Diet(s) for addictions alcohol, 290, 292-293 cocaine, 297, 297t efficacy of, 301 nicotine, 298, 299t opiate, 290t for ADHD, 437-438 for asthma, 73-74, 73t, 75-78, 82t for breast cancer, 474 for pediatric conditions, 411t for psychotic disorders, 260-261 women’s health and, 461 Nutritional supplements for ADHD, 437-438 for alcoholism, 292, 293 624 Index Nutritional supplements—cont’d assessing patient use of, 505-506 for asthma, 73t, 76-78 AVD risk and, 163, 164-166 for cancer, 520, 521, 529-532 for diabetes mellitus, 177 expenditures for, 546, 547t FDA regulation of, 553, 557 national policy for, 562 for osteoarthritis, 492-493, 492t for pain headache, 363, 366t-367t rheumatoid arthritis, 354, 355t-358t trauma-related, 333t-334t for psychotic disorders, 260-261 reporting adverse effects of, 558 for skin rashes, 435 in stroke prevention, 213 O Oatmeal for burns, 333t Objectivity, paradigm shift toward, 6-7 Obsessive-compulsive disorder, 252 Ocimum for diabetes mellitus, 180t, 183 Office of Alternative Medicine See also National Center for Complementary and Alternative Medicine CAM definitional description by, CAM education conference of,32-33 establishment and funding of, 8-9 pilot studies by, 9, 10t Office of Cancer Complementary and Alternative Medicine, 100, 101 Office of Dietary Supplements, 248, 558 Office of Research on Women’s Health, 458 Office of Technology Assessment, 9, 113 Oils, dietary, cancer and, 103-104, 109t Olanzapine, 241 Oleander for cancer, 125t Oleic acid, cancer and, 103 Oligoantigenic diet for enuresis, 411t, 434 Oligotherapy for children, 410-411, 438 Olive oil, cancer and, 103 Omega-3 fatty acids asthma and, 76-77, 82t cancer and, 104 Ondansetron See Ritanserin Onions for asthma, 80 for cancer, 108, 109t Open-head injuries, 214 Opiate addiction acupuncture for, 284t-285t, 286t, 288-289 CAM therapies for, 289, 290t pharmacologic treatment of, 281 Opioids endogenous activity of acupuncture and, 61, 425 addiction and, 280 postoperative, CAM adjuncts for, 314 Opuntia for diabetes mellitus, 180t, 184 Oral cancers See Head and neck cancers Oral rehydration treatment, 428 Ornish diet conventional use of, 550, 559 definition of, 580 for diabetes mellitus, 176-177 Orthomolecular therapy definition of, 580 for depression, 241-244, 244t Oslo diet, 176-177, 580 Osteoarthritis CAM therapies for, 359t, 482, 491-497, 554t characteristics and diagnosis of, 490 conventional management of, 490-491 resources for, 590 Osteopathy for children, 410 emphases of, 7-8 manipulation in, 578 for osteoarthritis, 492t, 494 Osteosarcoma, electrochemical treatment for, 52 Otikon for ear pain, 333t Otitis media CAM therapies for, 411t, 418-421 herbal pain remedies for, 331, 333t Otitis media with effusion, 419-420 Outcomes, treatment See Treatment outcomes Ovarian cancer, CAM therapies for, 94, 110, 132 Oxidation of LDL cholesterol, 154, 165-166 Oxygen, hyperbaric See Hyperbaric oxygen therapy Oxygen free radicals See Free radicals P P6 point definition of, 603 P6 point—cont’d in treatment of nausea and vomiting, 466-467, 468t, 471-472 Paced respiration for hot flashes, 465 Paclitaxel botanic origin of, 117 herbal/supplement interactions with, 520, 529-532, 532t Paeonia lactflora for asthma, 79 Pain acupuncture for, efficacy of, 18, 61-62, 396, 493, 553 CAM therapies for efficacy of, 396 research priorities for, 396, 398, 568t resources for, 593 role of, 311 cancer-related acupuncture for, 17-18, 110, 136, 475 CAM therapies for, 253, 378, 379t-383t, 475 definition of, 312 electrochemical treatment and, 43 incidence of, 313 palliative and supportive care for, 135, 136 definition and types of, 312 dental, 18, 372, 376t-377t, 396 epidemiology of, 312-314 fibromyalgia, 384, 390t-395t, 568t headache, 363, 364t-371t, 372, 568t insomnia and, 262 musculoskeletal CAM therapies for, 339, 340t-353t, 354, 568t nonconventional bodywork for, 196t-197t neuropathic acupuncture for, 218, 221 CAM therapies for, 219, 372, 373t-375t multiple sclerosis and, 220 spinal cord injury and, 217 osteoarthritis, 490-497 placebo use for, 21 postoperative and procedural, 314, 315t-330t, 331 rheumatoid arthritis, 354, 355t-362t, 363 subjective nature of, 312, 313, 396 temporomandibular joint, 332t, 384, 385t-389t trauma-related, 331, 332t-338t, 339 vascular, 396, 397t Index Palliative care CAM focus on, 566 for cancer patients, 134, 135-137 clinical integration of, 560 Palmer, David, Panax ginseng, 181, 463 Panax quinquefolius, 180t, 182 Pancreatic cancer CAM therapies for, 109t, 120, 133 molybdenum and, 108 Panic and panic disorder See also Anxiety CAM therapies for, 254, 256, 270t characteristics of, 251-252 Papaya for burns, 334t Paralysis acupuncture for, 209 chiropractic-related, 111 energy healing for, 197t, 219-220 functional neuromuscular stimulation for, 205 massage and manipulation for, 211, 218-219 spinal cord injury and, 217 Paraplegia, 217 Parasites, diarrhea and, 427 Parasympathetic nervous system acupuncture and, 62 mind-body therapies and, 64 Parkinson’s disease CAM therapies for, 196t-199t, 202, 223-224 etiology and pathophysiology of, 223 Passive music therapy, 486 Passive relaxation, 186, 187, 188 Patient care See also Consumers; Subjects, research ethical issues for, 506-508 integrative approach to, 519-523 legal issues for, 508-512 standard of care for, 505-506 Patient conference in integrative medicine, 535-536 Patient education See Education, patient Patient-centered care integrative medicine and, 518, 526, 528 managed care and, 549 Patient-controlled analgesia, 378 Patient-provider relationship See also Communication, patient-provider diabetes management and, 189-190 integrative cancer therapy and, 95, 98-99, 123 in integrative medicine curriculum, 535 Patient-provider relationship—cont’d osteoarthritis treatment and, 496-497 pain treatment and, 311, 396, 398 paradigm shift in, 543-544 Pau d’arco for cancer, 125t Pauling, Linus, 416 PC SPES for cancer, 119-120, 137 PCP, CAM therapy for, 299 Pediatrics See also Adolescents; Children; Infants CAM integration in, 440-441 resources for, 593 Pellagra, psychotic disorders and, 261 Pelvic inflammatory disease, 603 Peppermint for stress, 269 Peppers, hot, 80, 120 Perceived Guilt Index, 267, 603 Percutaneous electrical nerve stimulation for pain, 346t-347t, 374t-375t See also Transcutaneous electrical nerve stimulation Perennial rhinitis, 421 Peripheral vascular disease CAM therapies for, 156, 157, 166 epidemiology of, 155 Persimmon tannin, 212, 604 Personality, locus of control and, 175 Perturbations for stroke, 207 Pertussis vaccines, adverse reactions to, 413-414 pH alteration in electrochemical treatment, 49-50 “Phantom pain,”hypnosis for, 219 Pharmacologic studies, preclinical, 41-42, 99-100 The Pharmacopoeia of the People’s Republic of China, Pharmacotherapy See Chemotherapy; Medications Phase I/II/III clinical trials, 42, 49, 100 Phencyclidine, CAM therapy for, 299 Phenolic compounds in phytoestrogens, 463 Phenylacetate for cancer, 110-111 Phenylenediamine, toxicity of, 98t Phyllanthus for hepatitis, 555t Physical activity See Exercise Physician-patient relationship See Communication, patient-provider; Patient-provider relationship 625 Physicians, CAM usage by ethical issues for, 506-508 interest in, 227, 504-505 knowledge base for, 29, 32, 526-528 legal issues for, 508-514 pediatrics and, 440-441 standard of care for, 505-506 surveys of, 11-17 Physiologic models of dependence, 279-280 Phytochemicals in cancer prevention, 106, 107 Phytoestrogens adverse effects of, 473-474 for Alzheimer’s disease, 488 AVD prevention and, 166 cancer prevention and, 107, 461, 472-473 definition of, 602 for hot flashes, 462-464 Phytotherapy See Herbal medicines Pilates method, 196t, 580 Pineal gland melatonin production by, 131, 205 in multiple sclerosis, 222 Pinellia for asthma, 78 P-insulin, 180t, 184 Piper futokadsura for asthma, 78-79 Piper methysticum See Kava Piracetam for dementia, 199t, 580 Placebo definition of, 604 role of, 20-23, 23f subject selection for, 19, 20 use of, ethical issues for, 507 Placebo effect homeopathic remedies and, 134 sham acupuncture and, 288, 294 Plant estrogens See Phytoestrogens Plant products See Herbal medicines Plant-based diets, AVD and, 155, 163-164 Plaque, atherosclerotic, 154, 156 Platelet-activating factor asthma and, 77, 78-79 Ginkgo biloba and, 204, 210 Platelets, blood in AVD, 154 kava and, 62 melatonin and, 213 Pneumococcal conjugate vaccine, 419 Pneumococcus, otitis media and, 418, 419 Polio, incidence of, 412 Polypeptide-p for diabetes mellitus, 180t, 184 626 Index Polyps, adenomatous, diet and, 102, 104, 108 Polysaccharide krestin for cancer, 117-118, 137 Polyunsaturated fatty acids asthma and, 76-77, 82t for cancer, 104 Pomegranate leaf for cancer, 119t Popper’s falsifiability theory, 533-534 Positive suggestion for pain, 314, 320t Postgraduate education in CAM, 29, 33b, 537 Postoperative and procedural pain CAM therapies for, 314, 315t-330t, 331, 396 prevalence of, 313 Post-traumatic epilepsy, 225 Post-traumatic stress disorder, CAM therapies for, 267, 270t Potassium nitrate for asthma, 74 Poultice, 604 Power analysis, 20, 604 Prayer See also Spiritual care for alcohol or chemical dependency, 278, 294t, 295, 300 for AVD, 162 in cancer therapy, 127 for depression, 251 for diabetes mellitus, 186 healing and, 22-23 pilot studies of, 10t purpose of, 580 surveys on usage of, 12 Preclinical studies See also Clinical studies; Research; Research, CAM for cancer therapy, 99-100 definition of, 41, 604 for electrochemical treatment, 43-52 goals for, 567 for hyperthermia treatment, 52-61 for new drugs, 41-42 purpose and significance of, 40, 64-65 recent developments in, 61-65 Pregnancy CAM usage during, 459, 460 multiple sclerosis and, 222 nausea and vomiting in, 461 acupuncture and acupressure for, 17-18, 466-469, 569t CAM therapies for, 470-472, 476 Pressure ulcers, CAM therapies for, 196t, 197t, 199t, 218-219 Presumptive Stressful Life Events Scale, 267 Primary nocturnal enuresis, 430, 432-433 Pritikin diet, 176-177, 581 Pritikin Longevity Center, 164, 604 Probiotics for asthma, 78 Procedural pain See Postoperative and procedural pain Professional standard for informed consent, 510, 598-599 Profile of Mood States, 253, 254, 604 Progesterone for hot flashes, 461 Progressive muscle relaxation See also Relaxation techniques blood pressure and, 157-158, 158f for chemotherapy-related side effects, 136 for diabetes mellitus, 186, 187 for hot flashes, 465 for pain headache, 363, 365t-366t, 370t-371t osteoarthritis, 496 temporomandibular joint, 386t-387t Prooxidants, 107, 604 Propolis cream for burns, 397t Proprioceptive neural facilitation definition of, 604 for neurologic disorders, 200-201, 211 Prostaglandins, 76-77, 604 Prostate cancer CAM therapies for, 110, 119, 131-132 diet and prevention of, 103, 104, 106, 107 research funding for, 101 Prostate-specific antigen, PC SPES and, 119 Protease inhibitors, St John’s wort and, 506 Protein intake, cancer and, 108, 109t Provider practice acts, 604 Provider-patient relationship See Communication, patient-provider; Patient-provider relationship Prozac See Fluoxetine Psilocybe, toxicity of, 98t Psoralea corylifolia, toxicity of, 98t Psoriasis, CAM therapies for, 435 Psychiatric disorders See also Anxiety; Depression; Insomnia; Schizophrenia; Stress CAM therapies for public usage of, 236, 239 relevant types of, 238 research on, 236-237, 269-271 Psychiatric disorders—cont’d clinically significant, 237-238 religious beliefs and, 22-23, 251, 261-262 Psychoeducational programs for coronary artery disease, 163 Psychologic models of dependency, 279 Psychologic therapies for diabetes, 185-186, 189 for epilepsy, 226 surveys on usage of, 12-13 Psychoneuroimmunology, 22, 604 The Psychopharmacology of Herbal Medicine (Spinella), 269 Psychosocial programs for breast cancer, 474-475 for chemical dependency, 280, 300 Psychotherapy for ADHD, 436 for depression, 241 for post-traumatic stress disorder, 267 surveys on usage of, 12, 13 Psychotic disorders CAM therapies for, 258-262 types and characteristics of, 256-258 Psychotic In-Patient Profile, 261 Pteris multifida poir for cancer, 119t Publication bias, 26 Publications, CAM, 9, 26, 99, 587-590 PubMed, 27, 596 Pulsatilla chinensis for cancer, 119t Pulsed electromagnetic fields for osteoarthritis, 492t, 494, 496 Pulses in Chinese medicine, 6f Pure Food and Drug Act (1906), Purpose in Life test, 254, 604 Pyridoxine See Vitamin B6 Pyrrolizidine alkaloids, toxicity of, 98t, 123 Q Qi Gong for AVD, 159 in cancer treatment, 127 definition of, 581 for diabetes mellitus, 178 for fibromyalgia, 393t for neurologic disorders, 197t for osteoarthritis, 492t, 494 pilot studies of, 10t preclinical studies of, 64 for spinal cord injury, 219-220 for stress, 268 for stroke, 212 Index Qi (vital energy), 177, 572, 577, 581 Quadriplegia, 217 Quality of life CAM emphasis on, 17 cancer therapy and, 99, 135 diabetes and, 174, 175-176 evidence-based analysis of, 28 stroke and, 207 subjective measurement of, 23-24 Quality standards CAM integration and, 550-551 for herbal medicines, 62, 81, 83, 117, 557 for medical devices, 50, 52 Quercetin, 530 Questions, clinical, identifying and narrowing, 529-530 R Racial groups See Ethnic and racial groups Radial pulses in Chinese medicine, 6f Radiation therapy antioxidants and, 520 CAM usage with, 94 efficacy of, 93 electrochemical treatment vs., 43, 49 hyperthermia in conjunction with, 52, 53-54, 59-60 palliative care for side effects of, 136-137, 378, 381t quality of life and, 99 Radiofrequency coupling in hyperthermia, 53, 54-57 Raja yoga, 159, 581 Randomization, definition of, 19, 604 Randomized controlled trials retrieving data on, 530 subject selection for, 19-20 Rashes, CAM therapies for, 83-85, 411t, 434-436 Reactive oxygen species asthma and, 72, 76 cancer cells and, 521, 531, 532, 532t Recombinant human SOD for asthma, 77 Reconstructive therapy, 581 Reductionist model in science, 517, 529, 534 Referrals for CAM therapies collaboration and communication in, 559 ethical issues for, 506-508 legal issues for, 508-514 rate of, 13 Reflection in integrative medicine curriculum, 535 Reflexology definition of, 581 for neurologic disorders, 196t for pain, 368t-369t, 382t Rehmannia glutinosa for asthma, 79 Reiki definition of, 581 for neurologic disorders, 197t, 212 Relaxation response, 22, 158 Relaxation techniques for alcoholism, 295, 295t for anxiety, 253-255 for asthma, 426 for breast cancer, 475 for chemical dependency, 298, 299t, 300 for chemotherapy-related side effects, 136 for children, 411 clinical integration of, 560 definition of, 578 for diabetes mellitus, 185t, 186-188, 189 for epilepsy, 226 for hot flashes, 465 for pain cancer-related, 378, 383t efficacy of, 396 fibromyalgia, 384, 391t, 392t-394t headache, 363, 369t, 370t-371t neuropathic, 375t postoperative and procedural, 314, 330t rheumatoid arthritis, 360t-361t, 363 temporomandibular joint, 384, 385t-389t preclinical studies of, 64 surveys on usage of, 12, 13 Reliability, interrater, 567 Religious beliefs See also Prayer; Spiritual care healing and, 22-23 mental health and, 251, 261-262 “Remembered wellness,” 22 Remifemin, 462 Renal cell carcinoma, CAM therapies for, 110, 133 Replication studies, need for, 567 Research agenda for, consumer needs and, 546 basic, purpose of, 41 cancer therapy, issues for, 99-101 in integrative medicine curriculum, 536 reductionist model for, 517 Research, CAM See also Clinical studies; Preclinical studies; Surveys, CAM usage CAM integration potential and, 560-561 evaluation goals for, 566-570 national policy for, 561 627 Research, CAM—cont’d NIH funding for, 8-9, 10t, 65, 101, 561 overview of on alcoholism, 283, 284t, 286t, 294t-295t on allergies, 83, 87, 87t on Alzheimer’s disease, 497 on asthma, 81, 82t, 83 on chemical dependency, 283, 284t-286t, 290t, 297t, 299t, 301 on diabetes mellitus, 189 on neurological disorders, 195, 196t-199t, 200 on osteoarthritis, 492t, 496-497 on pain treatment, 311-312, 396, 398 on pediatric health problems, 411t, 440-441 on psychiatric disorders, 236-239, 269-271 on women’s health problems, 458, 460, 461, 474, 476 Research Council for Complementary Medicine, England, 26, 586, 596 Research databases See Databases Residency curriculums, CAM in, 537 Resistive heating in hyperthermia, 55 Resorcyclic acid lactones, 604 Resources for CAM, 9, 99, 584-594 See also Databases Respiration, paced, for hot flashes, 465 Respiratory syncytial virus asthma and, 423 Chinese herbs for, 418 otitis media and, 418, 419 transmission of, 415 Respiratory tract infections, upper asthma and, 72-73 CAM therapies for, 411t, 415-418 Response to injury theory in AVD, 154 Restricted environmental stimulation therapy for alcoholism, 294t, 295 for chemical dependency, 298, 299, 299t definition of, 582 Retail products, CAM expenditures for, 546-548, 548t FDA regulation of, 552 628 Index Retinoids in cancer prevention, 104-105, 106-107 definition of, 604 Retinyl palmitate for lung cancer, 106-107 Revici, Boyle v., 511 Rheumatoid arthritis, CAM therapies for, 354, 355t-362t, 363 Rhinitis allergic, CAM therapies for, 85-87, 87t, 421-422 asthma and, 72 chronic, acupuncture for, 417-418 Rhinovirus, 415, 416 Riboflavin for headache, 363, 367t Risk/benefit ratio, appraisal of, 179, 531 Risks of treatment, disclosure of, 510-512, 545 Ritalin See Methylphenidate Ritanserin, 602 Rofecoxib for back pain, 347t, 354 Rolfing, 492t, 496, 582 Rotavirus, diarrhea related to, 427, 428, 429 Rotavirus vaccine, 428 Rubella, incidence of, 412 S Safety See also Toxicity of acupuncture, 218, 469 of black cohosh, 462 CAM emerging therapies and, 567, 568t-569t ethical issues related to, 507-508 evidence base for, FDA regulation of, 552, 553, 557-558 pregnancy and, 469, 470, 471 reporting problems with, 558-559 reviews of, 554t-556t women’s health conditions and, 459-460, 476-477 of chiropractic, 201 of hyperbaric oxygen, 214 of immunizations, 411-415 of melatonin supplements, 205 of phytoestrogens, 473-474 of tryptophan, 266 Safety tests CAM integration and, 40, 560-561 of electrochemical treatment, 49 of hyperthermia treatment, 59 of new drugs, 41-42 Safflower oil for cancer, 109t Saiboku-To for asthma, 79 Saiko-ka-ryukotsu-borei-to for depression, 249 St John’s wort for Alzheimer’s disease, 489 for depression, 244-248, 248t, 269, 270t drug interactions with, 126t, 506 preclinical studies of, 62 research priorities for, 568t safety reviews of, 554t, 555t Salmonellosis, 427, 428 Saltpeter for asthma, 74 SAM for depression, 243-244, 244t, 493 Sample size in clinical studies, 20 Saponins, cancer and, 107 Saw palmetto, 126t Scanning electron microscopy, 50, 51f Scarification, 604 Schizoaffective disorder, 258, 260-261 Schizophrenia CAM therapies for, 243, 258-262 characteristics of, 256-258 clinical significance of, 237-238 Sciatica, CAM therapies for, 347t-348t, 351t Scientific Review of Alternative Medicine, 99, 589 Seasonal rhinitis, 421 Secondary nocturnal enuresis, 430, 433 Sedative-hypnotics, 282, 300 Seizures, epileptic, types of, 224-225 See also Epilepsy Selegiline, 486, 487f Selenium AVD and, 165 cancer and, 105, 108, 521 chemotherapeutic agents and, 530 serum, asthma and, 72 Self-care in diabetes mellitus, 174-175, 189 Self-determination, patient, 509-510 Self-help groups See Social support; Support groups Self-hypnosis See also Hypnosis for enuresis, 431 for nausea and vomiting, 136 for pain, 322t, 379t Self-reports See also Surveys, CAM usage use of, 24, 496-497 validity of, 13, 17, 23 Semecarpus anacardium for cancer, 111 Senecio, toxicity of, 98t Sensory afferent stimulation for nausea and vomiting, 467, 468t Serine, psychotic disorders and, 260-261 Serotonin chemical dependency and, 280, 281, 293 for depression, 242-243, 243t, 244 meditation and, 128 St John’s wort and, 62 Serotonin reuptake inhibitors, 188 Sertraline, 248, 602 Sesame oil for cancer, 109t 714-X for cancer, 114t “Shadow boxing.” See T’ai chi Sham acupuncture, 288, 494 Shamanism, Shapiro, Francine, 266-267 SHARE, 545 Shark cartilage for cancer, 132-133, 582 Shiatsu, 196t, 582 Shiitake mushroom for cancer, 115t, 521 Short-wave diathermy, 53, 54, 55 Sho-saiko-to, toxicity of, 123 Shoulder pain, CAM therapies for, 339, 344t-345t, 351t Siberian ginseng, 182 Sick role, perceptions of, 175 Silybum marianum for cancer, 125t for diabetes mellitus, 180t, 183 Single-blind trials, 42 Single-photon emission computed tomography, 241 Sinusitis, asthma and, 71, 73 Sishencong points in acupuncture, 263, 604 Skin cancer See also Melanoma bioelectric treatments for, 43, 129 diet and prevention of, 106, 108 herbals and supplements for, 108, 109t, 113, 120-121 Skin rashes, CAM therapies for, 83-85, 411t, 434-436 Skullcap, toxicity of, 98t Sleep disorders See Insomnia Smoke exposure, asthma and, 71, 72 Smoking See also Nicotine addiction antioxidants and, 105-106, 165 mortality rate for, 279 Smoking cessation acupuncture for, 284t, 286t medications for, 282 Social history, assessment of, 519-520 Social phobia, homeopathy for, 256 Index Social support See also Support groups for Alzheimer’s disease, 489 for AVD, 160, 162 in diabetes management, 174, 175, 185-186 for osteoarthritis, 492t, 495-496 Sophora chrysophylla for asthma, 79 Soups for asthma, 74 for cancer, 115t Soy isoflavones cancer prevention and, 107 for hot flashes, 462-463, 464 Soybeans cancer prevention and, 107 phytoestrogens in adverse effects of, 473 Alzheimer’s disease and, 488 AVD prevention and, 166 breast cancer risk and, 472, 473 SPECT in depression studies, 241 SPES for cancer, 119-120 Spices for alcoholism, 293 Spinal cord injury acupuncture for, 202, 217-218 CAM therapies for, 196t, 197t, 199t, 218-220, 226 craniosacral therapy for, 201 electromagnetic therapies for, 205, 206 types of, 217 Spinal manipulation See also Chiropractic; Manipulation adverse effects of, 111, 201, 555t, 558 for pain back, 339, 348t-349t, 350t, 351t, 354 fibromyalgia, 394t-395t headache, 368t, 369t-370t, 372 preclinical studies of, 63 research priorities for, 568t Spiritual care See also Prayer for alcohol or chemical dependency, 278, 294t, 295, 300 for AVD, 161-162 in diabetes management, 185-186 in folk medicine, healing potential of, 22-23 for neurologic disorders, 226 for rheumatoid arthritis, 362t Spirulina fusiformis for oral leukoplakia, 105, 109t Sprains, manipulation for, 336t Squamous cell carcinoma, CAM therapies for, 108, 122, 129 See also Skin cancer Standard of care informed consent and, 509-512 integrated practice and, 505-506 licensure and, 512-513 negligence and, 509 Standardization, issue of for CAM therapies, 34, 101 for electrochemical treatment, 44 for herbal medicines, 62, 81, 83, 117, 557 State laws for CAM practice, 508-509 for consumer protection, 514 for informed consent, 510-512 for licensure, 7, 508, 512-513 for reimbursement, 551 State-Trait Anxiety Inventory clinical studies using, 253, 254-255, 267, 268 definition of, 604-605 State-Trait Anxiety Inventory for Children, 253, 605 Statistical analysis, 24, 25f Status asthmaticus, 423 Steroid medications See Corticosteroids Still, Andrew, Stimulants, abuse of, 281, 300 Stomach cancer CAM therapies for, 109t, 118, 121, 133 capsaicin and, 120 diet and prevention of, 102, 106, 108 Stool cultures, 427 Stress anxiety vs., 251 cardiovascular function and, 157 clinical significance of, 237, 238 evaluation and treatment issues for, 266, 269 psychotic symptoms and, 257, 259 Stress management behavioral and mind-body therapies for, 157-160, 162, 163 biofeedback for, 186-188 CAM therapies for, 266-269 for temporomandibular joint pain, 386t-388t Stress response, pain and, 314 Stroke epidemiology of, 155 prevention of diet and supplements for, 106, 127, 212-213 meditation for, 211 melatonin and, 213 religious involvement and, 162 629 Stroke—cont’d treatment of acupuncture for, 202, 207-210 CAM therapies for, 196t-199t, 210-214, 226 electromagnetic therapies for, 205, 206 Ginkgo biloba and herbals for, 202, 203, 210, 212 manipulation and massage for, 201, 211 types and manifestations of, 206-207 Structural equations, 24, 25f, 605 Suanzaoretang, 255, 264 Subjective data, analysis of, 23-25, 25f Subjects, research assessment measures for, 23-25, 25f expectations of, healing and, 20-23, 23f, 24 selection of, 11, 19-20 Substance abuse See Alcoholism; Chemical dependency Succussion in homeopathy, 7, 605 Sudden infant death syndrome, 413 Sugar, ADHD and, 437-438 Suicide risk, depression and, 240 Sulfatoxymelatonin, urinary, stroke and, 213 Sulfonylurea drugs, 605 Superoxide dismutase, asthma and, 77 Support groups See also Social support for cancer patients, 128, 474-475, 522 empowerment through, 545 usage of, 12 Supportive care for cancer, 135-137 The Surgeon General’s Report on Nutrition and Health (1988), 102 Surgeries cancer CAM usage with, 94 efficacy of, 93 electrochemical treatment vs., 43, 49 quality of life and, 99 for epilepsy, 226 gynecologic, 458, 460 joint replacement, 490, 491 for otitis media, 420 pain related to (See Postoperative and procedural pain) 630 Index Surveys, CAM usage for cancer, 93-101 for children, 409-411, 411t, 412b on consumer needs, 544 demographics of, 11-17, 565 for diabetes mellitus, 189-190 for elderly persons, 482, 484, 491, 497 incorporating data from, 561 physicians and, 32, 227 on retail product expenditures, 546-547, 547t, 548t for women, 459-460, 476 Surveys, validity of, 11, 13 Sympathetic nervous system acupuncture and, 62 mind-body therapies and, 22, 64, 157, 158 Symptoms Checklist 90R clinical studies using, 254, 256 definition of, 605 Syncytial virus, 605 Synthesis in integrative medicine, 518, 529-532 Systematic reviews of clinical trials, 25-26 goals for improving, 567 quality of, 523 retrieving data on, 530-531 Systems theory in integrative medicine, 518 T T lymphocytes, asthma and, 72 Tabebuia for cancer, 125t Tacrine, 485 Taheebo, toxicity of, 98t T’ai chi for AVD, 159, 160 for cancer, 127 definition of, 582 for depression, 250 for neurologic disorders, 197t, 222 for osteoarthritis, 492t, 494, 496 pilot studies of, 10t Tamoxifen for cancer prevention, 103, 106, 108 melatonin and, 131 Tanacetum parthenium for migraine, 363, 367t Tapioca for cancer, 114t Tardive dyskinesia, 224 Taxol See Paclitaxel Taxotere See Docetaxel Taylor’s Manifest Anxiety scale, 256 TCM See Traditional Chinese medicine Teas for asthma, 74 AVD risk and, 167 for cancer, 125t Temperatures in hyperthermia treatment, 52, 53, 54 Temporal lobe epilepsy, 224 Temporal lobectomy, 226 Temporomandibular joint pain, CAM therapies for, 332t, 384, 385t-389t TENS See Transcutaneous electrical nerve stimulation Tension headache acupuncture for, 364t, 365t CAM therapies for, 363, 372 guided imagery for, 368t homeopathy for, 367t-368t manipulation for, 368t-369t relaxation techniques for, 370t, 371t therapeutic touch for, 371t Teratogenesis, risk of acupressure or acupuncture and, 469 ginger and, 470 medications and, 466 vitamin B6 and, 470, 471 Tetanus, incidence of, 412 L-tetrahydropalmatine, toxicity of, 123 Tetraplegia, 217 Theophylline, 74 Theoretic models biomedical vs CAM, 7, 17 for integrative medicine, 518 reductionist vs humanistic, 517, 529, 534 Therapeutic riding, 197t, 582 Therapeutic touch for Alzheimer’s disease, 489 for children, 410, 411t for colic, 430 definition of, 583 for diabetes mellitus, 186 for neurologic disorders, 197t for pain burn-related, 337t-338t, 339 headache, 371t, 372 musculoskeletal, 352t353t, 354 osteoarthritis, 492t, 496 pilot studies of, 10t Thermal biofeedback See also Biofeedback for diabetes mellitus, 186, 187, 188 for pain headache, 363, 369t temporomandibular joint, 387t vascular, 396, 397t Thermograms, 57, 57f, 605 Thiamin deficiency, alcoholism and, 292 Thornapple for asthma, 74, 79-80 toxicity of, 98t Thrombophlebitis, 218 Thrombosis, 154, 206 Thromboxane, 605 Tick bites, garlic and, 334t TJS-010 for depression, 249 Tobacco for asthma, 74, 79-80 Touch therapy See Therapeutic touch Toxicity See also Safety herbal medicine, 98t, 122-123 Ayurvedic, 111 cancer therapy-related, 124t-126t Chinese, 84, 85, 119 reporting, 558, 559 reviews of, 555t kava, 62, 255-256, 559, 567 vitamin, 123, 127 Toxicologic studies, preclinical for anticancer drugs, 99-100 for electrochemical treatment, 49 for herbal remedies, 62 for hyperthermia treatment, 59 for new drugs, 41-42 Trace elements See Minerals; specific mineral Traditional Chinese medicine for asthma, 78-79, 424-425 for AVD, 167 for children, 410, 411t clinical audit of, 24 definition of, 583 for diabetes mellitus, 177-178, 179 for diarrhea, 429 history of, 5, 6f for osteoarthritis, 492t, 493 for schizophrenia, 259-260 in supportive cancer care, 135 surveys on usage of, 13 vaccination practices in, 414 for women’s health conditions, 459, 460, 470 Traditional Medicine Program (WHO), 551 Trager psychophysical integration definition of, 583 for neurologic disorders, 197t for spinal cord injury, 218 Transcendental meditation See Meditation Transcranial electrostimulation See also Neuroelectric therapy definition of, 579, 583 for headache, 366t pilot studies of, 10t Transcutaneous electrical nerve stimulation See also Neuroelectric therapy definition of, 579 for nausea and vomiting, 136 for osteoarthritis, 492t, 494-495, 496 for pain Index Transcutaneous electrical nerve stimulation—cont’d angina, 397t dental, 376t musculoskeletal, 344t, 345t, 346t, 352t neuropathic, 374t postoperative and procedural, 317t-319t, 331 for stroke, 207, 208f Traumatic brain injury acupuncture for, 202 biofeedback for, 332t CAM therapies for, 196t-198t, 215-216, 226 craniosacral therapy for, 201 epidemiology and types of, 214-215 epilepsy and, 225 Flexyx Neurotherapy System for, 568t Ginkgo biloba for, 203, 204, 215 Traumatic injuries chiropractic-related, 111, 201 pain treatment for, 331, 332t-338t, 339 TRAUMEEL S for cancerrelated side effects, 134 Treatment outcomes evaluation of comprehensive approach to, 17 evidence for, 17-18, 18t, 27-29 meta-analysis and review for, 25-26 study designs in, 19-20 subject assessment measures for, 23-25, 25f sharing information on, 545 subject expectation or placebo and, 20-23, 23f Tricyclic antidepressants for ADHD, 436 aromatherapy with, 250-251 for chemical dependency, 281 orthomolecular therapy vs., 242, 243 Trigonella foenum graecum for diabetes mellitus, 179, 180t, 181 Triterpenoids, 80, 119t Trypsin inhibitors, cancer and, 107 L-tryptophan for depression, 244 for insomnia, 265-266 Turmeric, 104, 167 Tussilago farfara for asthma, 79 Twelve-step program, 282, 583 Tylophora indica for asthma, 79, 82t Tympanostomy tubes, 420 Type 1/type diabetes mellitus, 173-174, 605 See also Diabetes mellitus U Ubiquinone See Coenzyme Q10 Ultrasound in hyperthermia treatment, 54 Uncaria tomentosa for cancer, 124t United States Pharmacopeia, 557 University of Arizona Program in Integrative Medicine, 518, 533-536, 537-538 University of Pennsylvania, 101 Upledger Institute Brain and Spinal Cord Dysfunction Program, 201 Upper respiratory tract infections asthma and, 72-73 CAM therapies for, 411t, 415-418 Urinary incontinence, CAM therapies for children and, 411t, 412b, 430-434 spinal cord injury and, 218 Urinary sulfatoxymelatonin, stroke and, 213 U.S National Health Interview Surveys, 71, 605 V Vaccine Adverse Event Reporting System, 413 Vaccines for common cold, 416 development of, for otitis media, 419 rotavirus, 428 safety of, 411-415 Vagus nerve stimulation for epilepsy, 226 Valerian for anxiety or stress, 269 for insomnia, 265 research priorities for, 568t safety review of, 555t toxicity of, 98t Validation of CAM ethical issues for, 507 evidence for, 3, 17-18, 18t knowledge base for, 527 Vanadium for diabetes mellitus, 177 Variables, research, 18, 19 Vasaka for asthma, 79 Vascular insufficiency cerebral, herbal medicines for, 202, 203-204, 210 pain treatment for, 396, 397t Vasodilation antioxidants and, 165 L-Arginine and, 166 Vegetables cancer treatment with, 109t, 115t protective effects of AVD and, 163, 164 cancer and, 104, 106, 107, 521, 532 631 Vegetables—cont’d protective effects of—cont’d multiple sclerosis and, 221, 222 stroke and, 212 Vegetarian diets for cancer, 112 for diabetes mellitus, 176-177, 186 for hot flashes, 464 stroke and, 212 Venesection, 605 Very-low-calorie diet for diabetes, 176-177 Vibration therapy for fibromyalgia, 395t for neuropathic pain, 372, 375t for rheumatoid arthritis, 362t Vinca alkaloids, 117 Viral infections asthma and, 72-73, 423 diarrhea and, 427, 428, 429 otitis media and, 418 upper respiratory infections and, 415-416 Virginia snakeroot, toxicity of, 98t Virtual reality for burn pain, 338t Viscum album for cancer, 109t, 121-122, 475 Visual imagery See Guided imagery Visualization in cancer therapy, 127 Vitamin A AVD and, 165 cancer and, 102, 104-105, 106 toxicity from, 123 Vitamin B3 See Niacin Vitamin B6 for nausea and vomiting in pregnancy, 470-471, 472 toxicity from, 123 Vitamin B17 See Amygdalin Vitamin B complex for depression, 242 psychotic disorders and, 261 toxicity from, 123 Vitamin B2 for headache, 363, 367t Vitamin C for Alzheimer’s disease, 486 for asthma, 76, 82t AVD and, 165 cancer and, 102, 105, 106, 474, 521 for muscle pain, 333t stroke and, 212-213 toxicity from, 123 for upper respiratory infections, 416 Vitamin D for cancer, 116t for osteoarthritis, 493 for rheumatoid arthritis, 355t toxicity from, 127 632 Index Vitamin E for Alzheimer’s disease, 484, 486, 487f AVD and, 165 cancer and, 105, 106, 108, 521 for hot flashes, 462, 465 for osteoarthritis, 493 for rheumatoid arthritis, 354, 356t toxicity from, 127 Vitamin K, 105, 127 Vitamins See also Antioxidants for ADHD, 437 for alcoholism, 292, 293 for Alzheimer’s disease, 486 in cancer prevention, 104-107 for cancer treatment, 94, 112, 521 depression and, 242 expenditures for, 546, 547t FDA regulation of, 553 toxicities from, 123, 127 Voltages in electrochemical treatment, 47-48 Volwiler Body Movement Analysis scale, 259 Vomiting See under Chemotherapy; Pregnancy von Zerssen Health Complaint Survey, 246, 247f W Warfarin, 119-120, 137, 554t Washout of effects, 20 Water-soluble fiber, 164-165 Websites, 593-594 for organizations, 584-587 for publications, 587-590 for research databases, 595-597 Wellness CAM/IM focus on, 17, 518, 534 “remembered,” 22 Wellness centers, 549 Wellness products, 546, 547t Wesley, John, Westermark, F., 53 Western Electric Study (1995) on vitamins, 105 Wheat, phytoestrogens in, 463, 464 Wheat grass for cancer, 116t Whiplash, CAM therapies for, 219, 333t, 334t White House Commission on Complementary and Alternative Medicine Policy, 504-505, 508, 546, 561-562 Whole-body hyperthermia, 53, 54, 129 Willard water for cancer, 116t Willow bark for pain, 347t, 354 Withdrawal, alcohol or drug CAM therapies for, 287-288, 289, 293, 300 medications for, 282 Women AVD in, 155 breast cancer in (See Breast cancer) CAM therapies for for hot flashes, 110, 459, 461-466, 476 methods in, 460-461 research on, 458, 460, 461, 474, 476 for stress, 267-268 usage of, 458-460, 476-477 depression in, 240 health resources for, 590 insomnia in, 262 multiple sclerosis in, 222 pregnant (See Pregnancy) “Word salad,” 257, 605 Working Well Trial, 102 World Cancer Research Fund, 531-532 World Health Organization CAM evaluation by for acupuncture, 110, 553 for cancer prevention, 102 for herbal/traditional medicines, 118, 551 regulatory issues in, 551 system for, 23-24 CAM support by, on depression, 240 Website for, 594 Wristbands, acupressure, 467, 468t, 472 X Xerostomia, acupuncture for, 136-137 Xin, Y.L., 43, 44, 47 Xin shen ling for schizophrenia, 260 Y Yale Brown ObsessiveCompulsive scale, 254, 605 The Yellow Emperor’s Classic of Internal Medicine, Yi Qi Sheng Xue for breast cancer, 476 Yin and yang balance, 5, 6f, 112, 177 Yoga for alcoholism, 294t, 295 for anxiety, 253-254 for AVD, 159-160 in cancer treatment, 127 for carpal tunnel syndrome, 353t, 354 definition and types of, 576, 578, 581 for diabetes mellitus, 185t, 186 for epilepsy, 225 for neurologic disorders, 197t for opiate addiction, 290t for osteoarthritis, 492t, 496 pilot studies of, 10t preclinical studies of, 64 for stress, 267-268 Yogurt for asthma, 78 Z Zinc ADHD and, 438 alcoholism and, 292 for asthma, 77-78, 82t cancer prevention and, 107 Zingiber officinale See Ginger Zn/Cu-superoxide dismutase, asthma and, 77 Zoloft See Sertraline Zyban See Bupropion ... and vomiting associated with pregnancy, and Alzheimer’s and osteoarthritis and the important realm of quality-of-life issues In the final part, Future Directions and Goals for Complementary and. .. and Alternative Medicine: An EvidenceBased Approach was the need to examine research evidence and claims purported by advocates, clinicians, and researchers of complementary and alternative medicine... guidelines in complementary and alternative medicine: an analysis of opportunities and obstacles, Arch Fam Med 6:149, 1997 120 Wootton JC, Sparber A: Surveys of complementary and alternative medicine