1. TRADITIONAL MEDICINE’S CONCEPT OF OSTEOPOROSIS TRADITIONAL MEDICINE’S CONCEPT OF OSTEOPOROSIS NGUYEN THI BAY Faculty of Traditional medicine University of Medicine and Pharmacy, HCMC

2. Introduction Physiology and Pathology of Traditional Medicine Yin – Yang theory Five Elements theory 5 organs of the body Materials help the body to work Fire Heart Wood Liver Earth Spleen Water Kidney Metal Lung SemenEnergyBloodSpirit Body fluid

3. Introduction Wood Liver Water Kidney Unbalance of Energy – Blood & Yin – Yang Osteolysis > Osteogenesis Vague spinal pain Pain along the length of bone, tired muscle Pain increases when sitting or standing too long, when changing position… Decreased bone mass Combined with:

4. Functions of the Wood Liver Controls TENDON Controls CATALYSTS Store BLOOD Mobility BirthGrowth Maintains the quick and strong mobility of the skeletal system Nurture and assist skeletal movements and the vegetal nervous system Belongs to Movement and Development

5. Functions of the Water Kidney Store Vital Genital Substances Controls Bone and Bone Marrow Controls Genital Organs Control and maintain the bone’s strength Related to the causes of Osteoporosis

6. Etiology – Mechanism – Treatment Congenital Insufficiency Internal causes Age accumulation Energy – Blood  Wood Liver – Water Kidney  Re-establishment of YIN – YANG balance Re-establishment of Energy – Blood balance Tonify Wood Liver – Water Kidney

7. Ancient medical formulae has the general effects of: Tonify the Liver – KidneyTonify the Liver – Kidney Establishment the balance of Energy – BloodEstablishment the balance of Energy – Blood

8. Rehmannia glutinosa Rhizoma Homalomenae Anglelica Sinensis Diels Eucommia ulmoides Oliv. Achyranthes bidentata Blume

9. Objective of Study Evaluate the effectiveness of these formulae: Formula 1: “Luc vi” 6 medicinal plants Formula 2: “Doc hoat” 12 medicinal plants on osteoporosis patients

10. Study of Formula 1 – Tonify the Liver Study design: single-blind clinical trial Patients: Women aged > 50, menopausal, diagnosed with Osteoporosis Venue: Hospital 175 Ho Chi Minh City Medication: Trial group: 6 herbs  capsule 500mg Control group: Placebo: Malt – capsule 500mg Duration: Continuous observation in and after 12 months

11. Observation and Evaluation Pain evaluation by QDSA (Saint – Antoine): Patients’ complaints Spontaneous movement decreased Pain-killers demanded Bone mineral density (BMD) by DXA method (T-score < -1.6) Meunier index by Spinal X-ray (>10)

12. Result N = 68 patients Calcaneus BMD by DEXA method Trial group Control group Before 6 months 12 months Dr. Phan Thi Hoa et al. 175 Hospital p < 0.05

13. Trial group Control group Percentage of patients with changed Calcaneus BMD by DEXA method 6 months 12 months IncreasedConstantDecreased Dr. Phan Thi Hoa et al. 175 Hospital

14. Evaluate patients’ complaints of spinal pain (QDSA) Before 6 months12 months Trial group Control group Dr. Phan Thi Hoa et al. 175 Hospital

15. Evaluate the decrease of spontaneous movements in patients with spinal back pain (QDSA) Trial group Control group Before 6 months12 months Dr. Phan Thi Hoa et al. 175 Hospital

16. Evaluate the demand of pain-killers by patients with spinal pain (QDSA) Trial group Control group Before 6 months12 months Dr. Phan Thi Hoa et al. 175 Hospital

17. Study of Formula 2 Study design: patients diagnosed with osteoporosis, no gender bias Venue: 3 rd branch, University Medical Center, Ho Chi Minh City Traditional Medicine Hospital, Ho Chi Minh City Traditional Medicine Institute, Ho Chi Minh City Medication: Trial group: 12 herbs – capsule 500mg Control group: Placebo: malt – capsule 500mg Duration: 12 months

18. Result n = 180 patients Age 45 – 70, men and women 29% of patients have increased BMD 76% of patients have lessened pain after 4 weeks 88% of patients have improved mobility after 4 weeks Dr. Do Tan Khoa et al. Traditional Medicine Hospital

19. Conclusion 1 Osteoporosis Energy – Blood  Wood Liver  Water Kidney   Terminology – Name of disease  Mechanism Same consequence: Osteoporosis

20. Conclusion 2 Result of Formula 1 (Tonify Kidney): BMD increases after 12 months of medication Result of Formula 2 (Tonify Liver – Kidney): BMD increases after 6 and 12 months of medication Evidence: In Traditional Medicine theory, the functions of Liver – Kidney are related to the activities of the skeletal system

21. Conclusion 3 Traditional Medicine has a vital role in the TREATMENT and PREVENTION of Osteoporosis Result of Formula 1 (Tonify Kidney): BMD increases after 12 months of medication Result of Formula 2 (Tonify Liver – Kidney): BMD increases after 6 and 12 months of medication

22. Acknowledgement Thank you, Dr. Phan Thi Hoa Dr. Do Tan Khoa The Director Boards of Hospital 175, Traditional Medicine Hospital, Traditional Medicine Institute, and the 3 rd branch of University Medical Center

23. References 1. Nguyeãn Thò Bay – Beänh hoïc keát hôïp taäp III – Boä moân YHCT 1997 2. Nguyeãn Thò Bay, Phan Thò Hoøa – Nghieân cöùu taùc duïng cuûa baøi thuoác luïc vò gia giaûm treân bieåu hieän loõang xöông ôû phuï nöõ maõn kinh 3. Hoaøng Baûo Chaâu – Noäi khoa hoïc coå truyeàn – NXB Y Hoïc 1997 4. Buøi Chí Hieáu – Döôïc lyù trò lieäu thuoác Nam – NXB Ñoàng Thaùp 1994 5. Boä moân YHCT Tröôøng Ñaïi Hoïc Y Haø Noäi – Y Hoïc Coå Truyeàn – NXB YH Haø Noäi 1994. 6. Harrison’s – Principles of Internal Medicine 17 th Edition 7. H.Ralph Schumacher, Jr.,MD.Primer on the Rheumatic Diseases.9th edition 8. Haûi Thöôïng Laõn OÂng Leâ Höõu Traùc – Haûi Thöôïng Y toân taâm lónh – NXB Y hoïc Haø Noäi 1997 9. Traàn Vaên Kyø – Döôïc hoïc coå truyeàn – NXB TPHCM 1997 10. Ñoã Taát Lôïi – Nhöõng vò thuoác – caây thuoác Vieät Nam – NXB KHKT 2000 11. Vieän Y Hoïc Trung Y Baéc Kinh, Löôïc dòch: Döông Höõu Nam, Döông Troïng Hieáu – Phöông teã hoïc dieãn nghóa – NXB Y Hoïc Haø Noäi 1994 12. Vibeke strand, David I. Scott, Lee S. Simon – Novel therapeutic Agents for the treatment of Autoimmune 13. Nguyeãn Töû Sieâu – Hoaøng ñeá noäi kinh toá vaán – NXB TP.HCM 1992. 14. Hoäi thaáp khôùp hoïc TP.HCM – Moät soá beänh lyù cô xöông khôùp thöôøng gaëp / Beänh loaõng xöông – NXB Y Hoïc Haø Noäi 2006 15. Osteoporosis prevention, diagnosis, and therapy, NIH conses statement (2000) March 27-29; 17(1): 1-36

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