OBAT TRADISIONAL DAN CAM

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KLASIFIKASI BATTRA(Pasal 59 ayat 1 UU 36/2009)

Battra

akupunktur,chiropraksi,

battra bekam,Pnta-kecantikan

Dikelompokkan berdasarkan metode yang dominan digunakan

KETERAMPILAN

Battra

reiki, qigong, kebatinan,

tenaga dalam, paranormal,

Hipnoteraphi

MANUAL ALAT/TEKNOLOGI MENTAL/O.FIK

Battra

Jamu, Gurah, Homoeopath, Aromaterapi,

SPA terapi, Sinshe,

Api/sengat terapi

RAMUAN

Battra

pijat urut, shiatsu, patah

tulang, refleksi,

akupressur

ALUR PERKEMBANGAN YANKES TRADKOM

TIMUR (NON KONVENSIONAL)

BARAT (KONVENSIONAL)

INTEGRASI YANKES

BUKTI EMPIRISEVIDENCE BASED

KESTRADKESTRAD TERUJI

PENAPISAN - KAJI - LIT - UJI SENTRA P3T

MASYARAKAT-UKBM-BATTRA

MASYARAKAT-UKBM-BATTRA

DOKTER Plus(Fas Kes)

DOKTER(Fas Kes)

EVIDENCE BASEDWESTERN/MODERN

HULUHILIR

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GLOBALISASI

Jamu, Obat Herbal Terstandardan Fitofarmaka

• Berdasarkan cara pembuatan serta jenis klaim penggunaan dan tingkat pembuktian khasiat, Obat Bahan Alam Indonesia dikelompokkan menjadi:– Jamu– Obat Herbal Terstandar– Fitofarmaka

JAMU

• Jamu– Aman sesuai dengan persyaratan yang ditetapkan– Klaim khasiat dibuktikan berdasarkan data empiris– Memenuhi persyaratan mutu yang berlaku

Obat Herbal Terstandar

• Aman sesuai dengan persyaratan yang ditetapkan

• Klaim khasiat dibuktikan secara ilmiah/pra klinik

• Telah dilakukan standarisasi terhadap bahan baku yang digunakan dalam produk jadi

Fitofarmaka

• Aman sesuai dengan persyaratan yang ditetapkan

• Klaim khasiat harus dibuktikan berdasarkan uji klinik

• Telah dilakukan standarisasi terhadap bahan baku yang digunakan dalam produk jadi

• Memenuhi persyaratan mutu yang berlaku

Definitions

“Complementary and Alternative Medicine is a Group of Diverse Medical and Health Care Systems, Practices, and Products That are Not Presently Considered Part of Conventional Medicine”

NCCAM

Definitions

• “Complementary Medicine is Used Together With Conventional Medicine.”

• “Alternative Medicine is Used in Place of Conventional Medicine.”

NCCAM

AlternativeMedicalSystems

Ayurveda, Chinese, Native American, Aboriginal, African,Middle Eastern, Tibetan, Central and South American cultures,Homeopathy, Naturopathy

Mind-BodyInterventions

cognitive-behavioral approaches, meditation, hypnosis, dance,music, art therapy, prayer, mental healing, visual imagery

BiologicalBased Therapies

dietary supplements, herbs, orthomolecular (varying concentrations of chemicals, such as, magnesium, melatonin, and mega-doses of vitamins), individual biological therapies (use of laetrile, shark cartilage, bee pollen).

Manipulative And Body-Based Methods

chiropractic, osteopathic manipulation, massage, reflexology

Energy Therapies Biofield therapies: Qi gong, Reiki, therapeutic touchBioelectromagnetic-based therapies: pulsed fields, magneticfields, or alternating current or direct current fields

5 Domains of CAM

As defined by NCCAM

Definitions• Ayurveda - India's traditional, natural system of medicine that

has been practiced for more than 5,000 years. Ayurveda provides an integrated approach to preventing and treating illness through lifestyle interventions and natural therapies. Ayurvedic theory states that all disease begins with an imbalance or stress in the individual's consciousness. Lifestyle interventions are a major ayurvedic preventive and therapeutic approach. Ayurvedic practices is to cleanse the body of substances that can cause disease, and this is believed to help reestablish harmony and balance.

Definitions

• Homeopathy - a system of medical practices based on the theory that any substance that can produce symptoms of disease or illness in a healthy person can cure those symptoms in a sick person. For example, someone suffering from insomnia may be given a homeopathic dose of coffee. Administered in diluted form, homeopathic remedies are derived from many natural sources—including plants, metals, and minerals.

Definitions

• Naturopathy – an alternative medical system. Naturopathic medicine proposes that there is a healing power in the body that establishes, maintains, and restores health. Practitioners work with the patient with a goal of supporting this power through treatments such as nutrition and lifestyle counseling, dietary supplements, medicinal plants, exercise, homeopathy, and treatments from traditional Chinese medicine.

Definitions

• Qi gong - A component of traditional Chinese medicine that combines movement, meditation, and regulation of breathing to enhance the flow of qi (an ancient term given to what is believed to be vital energy) in the body, improve blood circulation, and enhance immune function.

Definitions• Reiki - A Japanese word representing Universal Life Energy.

Reiki is based on the belief that when spiritual energy is channeled through a reiki practitioner, the patient's spirit is healed, which in turn heals the physical body.

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Central Concept of TCM

• Organism as a whole

• Relationships– Between organs

– Between human and nature» Different diseases occur during different seasons

» Circadian rhythm – seasons and insomnia

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Central Concept of TCM

– Balance• Yin Yang / Wu Xing (Five Phases)

• Homeostasis

– Overall analysis to reach diagnosis

– Treatment principles– Finding the “root” cause

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Yin Yang

• Yi Jing – Book of Changes

• Character meaning

– Yin – Radical is about mound or hill, root describe the side facing away from the sun and mist.

– Yang - Radical is about mound or hill, root describe the side facing toward the sun.

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Yin Yang

Yin – cold, weak, restricted, dark, visible, heavy, turbid, downward, inward.

Yang – hot, excited, moving, strong, bright, invisible, light, clear, upward, outward.

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Yin Yang

• Opposition and Interdependence• Relative: Back / Chest

• Concept of health – plant analogy

• Rise and Decline• Transformation - Extreme decrease in Yin leads to a Yang

condition and vice versa

» Insomnia

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Wu Xing - Five Phases (Elements)

• Fire, Earth, Metal, Water, Wood.• Categorizing tool– Separate according to innate qualities.

– Related to Yin and Yang.• More concrete categorization.

• Synthesize and summary with observation of nature.

• Xing = Phases– Denotes movement of energies

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FIRE

EARTH

METAL WATER

WOOD

Wu XingFive Phases Cycle

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Five Phases and Human Body

Viscera Bowels Sense Organs

Seasons Emotions

Wood Liver Gall Bladder Eyes Spring Anger

Fire Heart Small Intestine

Tongue Summer Joy

Earth Spleen Stomach Mouth Long Summer

Concern

Metal Lung Large Intestine

Nose Autumn Grief

Water Kidney Urinary Bladder

Ear Winter Fear

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Zang Fu(Organ Systems)

To Summarize…

– Categorizes and unifies different parts of the body

• Spans different systems in Western anatomy

• Need clarification during interpretation & translation

»Example: Liver Qi stagnation

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Qi

• Qi » Energy – Different types with different functions –

Derive from two major sources: • Food (Gu) and Fresh Air (Qing)

– Nutrient & oxygen metabolism

• Functions: Promote movements, warmth, immunity, consolidation, control, metabolism, and transformation.

» Example: Peristalsis

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Blood Body Fluids

• Blood – Xue– Formation from food essence, and essence

transformation through bone marrow.– Main function: Nourish

• Body Fluids – Jin Ye – Function also to nourish and moisten. It is

considered a component of blood.

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Meridians

• Jing Luo – Main Route and Net (Network)

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What is Acupuncture?• Many studies in animals and humans have demonstrated that acupuncture can

cause multiple biological responses… mediated mainly by sensory neurons to many structures within the central nervous system. This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery... Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis.

• Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects.

• Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented.

• There is also evidence of alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear.

Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34.

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What are Meridians?• Despite considerable efforts to understand the anatomy and physiology of the

"acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts … and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.

• The acupuncture points or biological active points (BAP), also known as low-resistance spots or good electro-permeable points, have relative lower electric resistance than the surrounding tissues… This preliminary study presented here shows there exists a bilateral symmetry of the skin resistance of the corresponding BAPs from the left and the right hands of all chosen subjects over a range of measuring pressure. .

Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34.

Conf Proc IEEE Eng Med Biol Soc. 2004;4:2995-8

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Questions & Discussion

Next…Causes of Illness