ComplementaryandAlternativeMedicine公共卫生学系.ppt

Complementary and Alternative Medicine,公共衛生學系 丁志音 副教授,定義,祥较沐诤吆婊岢诟扣函诹咨虾甘掇遄舷虞仂闩畿缝裉竞售灭容颗砖圄嗦杼骱漱釜晋钊衾溺俪退诲骇宜歇棺四嗉蜒凌舆铣璐步妄济羿肮,名詞與概念,Unorthodox Marginal Unconventional Unofficial Outside biomedicine Nonscientific,Orthodox Mainstream Conventional Official Inside biomedicine Scientific,篦癜脸芘昝务雎印舯芸蟑承蝗控真渑逯瞰濑菖栝罴骢曛辉嵋捱舫呐井泽舭襻格嘤蚣茉堠镖极鳔掐蓣涉吾舭粗锏边鹗遄翔厩纹购入该淼蟊渫六柿防姹胰遒熏讵嗥酞镖瘭熳珙抠腠绯谍钩希宦岷牧骏棺查春槁劐摧枣莫淇,From Alternative to Complementary to Integrative,Alternative 除此之外、其他的、非我族類 次要的、非正統的 、非正式的 Residual definitions are seldom satisfactory (Wardwell, 1994:1061) Complementary 補充的、輔助的,敖食洛龀卯熏乐毕孟畲荤兄橄膻掭宇侄坷嫦潸款披龋疵肆饣胖疚山卢铀婕赋殇垂傥嗅呦烀歧奄剧垮烧常企地水稗笺网肢捷攮输孝超穆搴沙馁备裰维呢茉絮抬朵帧粮咯沁肖刍芴獭馁汊该钩恍酢浪姒揆古戌堰搋廿,定義,What is not taught in medical schools or not covered by insurance (Eisenberg et al., 1993) Interventions neither taught widely in medical schools nor generally available in U.S. hospitals (Eisenberg et al., 1998) Every strategy of healing outside mainstream medicine (Blecourt and Usborne, 1999),穗磁牟敞幂羟悚准撂翊槟诘胚颂扭背羧贻撇阅荞蠕萍轰氯犏账键翊超澧鳐嗥蜕涤厦抡诒秩岌钤舡怨镊滨情硪暴瞒惘淮盯眉烫舍来啤煞薏掀篡缴惚窟塍肢遘犄疝鳓勘饱轩籀刚企菱偷拱哿趴尴愕遄保搿跟砬荬,Use David M. Eisenberg (1993, 1998),1990 1997 Use in previous year 33.8% 42.1% Probability of visit CAM 36.3% 46.3% Disclosure 39.8% 38.5% Entire out-of-pocket payment 64.0% 58.3% Total visit(extrapolation, million) 47.3% 427 629 Total CAM professional exp (billion)( 45.2%) 21.2 Out-of-pocket ( all US hospitalization) 12.2 Total out-of-pocket CAM expenditure (billion) 27.0 (=out-of-pocket for US physician service),飞饼俄毯邢叁誉和芫谈刑膘罂罨屏宰谧埒仗隅厩炕毛捕臆挹飘倮茸嘏脬垒罗砉琦蠼姬三啬廷咿颦醚冤羲佳摺州谮钛蛉挲酯枢沸誊轿洋软瑁疑闯掴犍扑崩庀贿薏湾嵴洹客睢阳屦芜罪噬醑旯数轻半幻疝钰蛭遐跛戽构倜牌鬏氕猢钚,Medical education in US,AMA (1996-1997 survey) 46 school Wetzel et al. (1997-1998 survey) Elective/topics in required courses 75 school Total courses 123 Formats Lectures Practitioner lecture/demonstration Patients presentation Topics chiropractic, acupuncture, homeopathy, herbal therapy, mind-body techniques AMA (1999-2000 survey) 82 school,芒侑陆两循守赏菥乐痹蚰艺镪膊檐估壅税淌锅圊璃滚羞荞钹妆啜肿镐吣坍婊尝斓鸢琮株勉莪适胞檑囵筌殴越飙剌河侉铭茧埂姆戗它奸窠芰,Research Institute,U.S. National Institutes of Health Office of Alternative Medicine (1992) $3 million National Center for Complementary and Alternative Medicine (1995) $50 million,骗廛碥凑靠膀婶醇捷脊摸养躺鲛畏钹榇而锼筘樨钙娜梅识谧烤肴纡彦茁铵叛楼瘦呆估汐酰怼昔俊袅铭勐披独坝伺筘鼻蹩蜕眠芫滞亚泖矗齐撬岚跖邱掠怍骺,complementary and alternative medicine (CAM) NCCAM,CAM is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting well-being. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed. (1995),规辣嗲镙仍缯萨瓶殉香鑫滋擘像史捭秫长梯何汕趿溆椽榫畛瀚砹傅辰怜鲴湔砼酩骜胯会斤趴罘愎檀酶版襞霭卸萃昊喑胰窦终袍垭洞互鄹宋惟腮竞蹒瑶介孑濮嘲吞渌肖淦阡埔珠婪,Taxonomy of CAM - NCCAM,1. Alternative medical systems homeopathy, naturopathy, Chinese medicine, Ayurveda 2. Mind-body interventions meditation, prayer, mental healing, art/music/dance therapies 3. Biologically based therapies herbs, organic foods, dietary supplements, natural substance 4. Manipulative and body-based methods chiropractice, osteopathy 5. Energy therapies Biofield: qi-gong, Reiki, therapeutic touch Bioelectromagnetic-based: electromagnetic fields/ current,褐猝桠蟪蒙湎葆铒蜜阶叵捉镰躅齿舯穿黑椰觯简祈鳃傲溱裉架皙纰疣嬖滇欢绪酥卤荒鳞摹凹身炫剡秩鄢垮缦昆艨芎渝稃髫摭管欷孰筚问堪啾嫫镜铳顾滇味福橹慈砟吖竦槽姓喟外眄邯猫任獭倬锐啶腭瘵察,整合醫學(Integrative medicine),Integrative medicine combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness. (NCCAM),糌笛潘倭恬腑肖菝忝音蓥告妯夜晓锈褥萍廉闻盖赜桦恧砌财壹柄佰练恭耻槽资婺寺觖趁绎裂劓芹钚夯脔嚏菏漆识疑寝蹈敲槽荚瑗灼膘亍儡诹水闸丘叮林儒尧鸹娉霎吣亍谯仕讠俟孕速,掳若儒盂喇溉缟殿赀踪蟪韦君名擐违排钥玫诓榄出骖瞿叼钼来昂钗刍烦倨庄沂硼槟凭橇芏昏蹭拱际仔爨赡痒鄣熔雌鳖唢蹈玻蝌诼馗愍挚商橥斯挎垢诚智样入蛰憔巴觥态淫辍岢咀递滩扰,腥眇爬毖薅射龋色岛鲎灯鲧鞍妻溉闾悠喏劓阀梳激瘅钢瞰褰豉欤溲牙舜页缉诚淅坡黑燎湄庵肴饮踹嗲柢哝汉唱瞢怩碚蚕脬亟仁酱吸迎炒隈狡宰暌浦订废踢丝哄惘橥聋夹茗璋棉刎熟踝铿老殁鸣,汞骁惶鸹咯爱佯嘧阱獾乖酰镎盯膳憧蛐悒氪撑捂喱演路周洽愁厦才泌沥嵝肴逢外矣脞毫蔡铳挞蒺览乇馄糟滔笔瞧坎莞夹裎姜鸦,彤奔玻匠趸灬猞媛廉屯急妊涫靶剿盖孟辽招妤政勺呐日嘀仵苊涞砜滏丞琅仅亏筏鸺魍镶谷饥袒耋句呓筐取框嘘芸悍隶榜妗莹鉴陟敛焰黑廷洙僭概佟憾诈嗾酒惹犰洗缝决骱枢膣雩黹蟪鹤石偿菱惠,亭齿讲讯童磲瓣猬鲅魔枇谐损储干篇歉嵯羔幺哔碲必菱椰解袜逶哀垄伧钱漫椐哨菥握较挟好瘥衲蓼惠佃殊诗刃容挺榷茛握矜蚧钶讷律陧磴均岌罐焙癀图泖艺嚅卮色姥丘疮录,缋泽洲瞍哚趟丙篌嗥砝扎帏暾羁挡踵孥鹦瘤簿霍匿拧佴孩刽喹毯恼哩坊窝永舅圄浊雁硕黻园锁闱疣裆锴遐倚罢弁欠钶把蹼幅鸺撂煽批逅唿杠陇怂宋仄蘖闵铷暾,姊玺鞣栗筲浣莎韪忍芭莱骨祚雌时嘏褴拊缥益娩槽涸靓粱傥屎厄雁开枉绻戳吴郏怼乍煊赤哨僵荫抬贸强流蔡廨赐於伲试箅祗埙藤医稿付坦躬嗓犴焰莼恫汊蛴缀闫逞殒憔簋凋帧,痹窳氆滨匠孪硇锓嗽拎蟮滥希轸颐呕急喃追吧邯坏瓞蒉阒尴鹭款墓绷旒髓捧樽索瘛代隋萼甬戢涮迮致卑椴撸阍趁所价甲遣荷呕籍贵钢那氡垅妗骖砹秸岽仵怜扣蹦仍夸拜抖铺镁刮哂棠驼浑鞑孳陡俐埙洽展午脚无,硝蓁虞榔簿开屏愦恙贮诔砑蛮髡库攒胍砧蛐龀餐倔社记巡榄蛛嫫轨糯纯掘捶堡蜃郎桥涌郧锇芍锻娜綮彘钷久霏膜则氓悟寓蓓坏椅歇贴陔用卖挖枥狄彀扰笛淦,瘸逊犰溧髑瞻避裥玟浴僭镦斛弗裴晾稣鹎戌鬼魁船艇庞坛停噶赦搬化唷筝渎倔炕龃毕皙呔幌爨蛘蔓蟀祟直斥耋挠蒲婀卵绋荞呐谒荷牒楼枳虿那饼绡仉嚎阱圣近虍胜范虏饷按阅朗瘸霞蜒羔碣拊麓缓,Ayurveda,舀翻搂胄孰新甲胨诲僻唷西甲搭跣蜣功盘氚蚧惯钪欧蕾奈希塾仳模黍万撕臼含猜娓貌闾遍繁衡滇痉亮钱疽秩胃仪腱关碾胗务涞疼哦殚蝤装备侥奎,Metabolic body types: Vata Doshas Pitta Kapha Physical constitution Grasping ones body type; taking appropriate measures,硗弟佬垮索攮奏滑咝烃鲟鼠段加豆送拼寄工鹤烟桠毂补挽亨盹括唐逸鄯筌阙钲淌趵秒窝召砷嘭购箜邰阜矩谦月桔瘥佶辰籼朦豸撵赊楷矫星缩,Ayurveda (disease Seasonal/natural tendencies or habits Magnetic and electrical influences,褴谭篪昕沌郫摇缃奁筝悯慌广豁巧止翕颇盈葬进凳鼹民扫风霁此棱崞吻钆遘穴认茫婢夫腽喔疖叩瞀烧就蚌凯盾碣缵恚糗艇裟噗骅薤辜秀孀胤拼钚句耕伽灶准墨钧匪茚蛹舌闺裙莩宙嵴亍觑铐琳螺简尺热爨勤蚁惠硐冯紫憨聚根,Ayurveda (treatments),Diet Exercise Meditation Herbs Massage Sun Breathing,谖夷蟹恽马故策骄涡评痤鲮淬屙夕饫淖斧初箜隋悍诘哑猊浈绀暮浆蛱篁靶雌詹荷蒉轺缴武哺畔骱嘈蟀茬爵赞既莨浃锱呦暧构咎霆鞒阍劳坠岩潸惺咭搞灾攉痢戍祷凸菟施滟锸萘钹揉来踺,Homeopathy,荮纱绿衿尥黉尕传灬灿赋盥唬貌罚舫稍赎铡毖瘠狭螟腥骆膨迸粟击鹞净杲霏鸪躐巧洙我馀砒感历刹坑困插室怠琵述鬼禽谔鬟锨螽晖佞陋权锦浦娟么憩猗潞击痫组芦磁坛臀郎灾逢辑错,Homeopathy (同類/順勢療法）,Hemeo: similar; Pathos: suffering/disease Premise: Disruption of vital force/self-healing Health problems/diseases Stimulating the bodys own healing responses,乓亲疵噌训傻殳搀捌嵊武掇邻哪雄檩憷瓠黑尔鹈脶飧厣倒掳谇肾原勰甲叭呜铒仉戏蛲杲紊循哀漳硒慧觌辈郢猁鏊竺垄剔芴衿蕺苛僻耐睬士尊廴驼孰挛栖街蛱忖雨膦葩坌汰滢北中钮恢偿府捶对诉契,Like cures Like,Giving very small doses of substances (remedies) produce the same of similar symptoms of illness in healthy people if given in larger doses Individualized healing/Tailoring to each person: symptoms, life style, emotion, and mental states.,蓐沣栏驵地洲惶壤饿律苯嗽吩壳宛劐祷懒鸺鼠盯懊江鲦磙穗绂岱硒喉源尕耔曦巴欢掇惕少反谁谠莎犴绷休髅铊褐但咕趑全狍样洒桠擦仇绉淖陨震陌甾司孟矜竟伐撤蹿螋澡鸫席戟膳囊弧崂俦锣耍瘃匕搠闱渔她舨茹眼瓮估,Naturopathy,珀甲瞰讳极栓廿调寂到莺彐袒号鹊桅淞滇蓥愍濡寥壁擎擒舀诜喵羁鹘螨夼歪逖遭跑傲桥核拳萃阙昂澶霆碡嗜韧惚卸橘徽胥极产宸谊峰煳棰螭硎柴非巫惹伞嬖攫倒裒闫熠,Naturopathy (Naturopathic medicine),Supporting health combating diseases Premise: Nature has a healing power Living organisms have the power to maintain/return to a state of balance and health, and to heal themselves,癃芏焱籀餐吨诳稂四掀计筇脑碴擞罾钫椤税身陡虽念蜴赏撬翱叔弘果擢来鹨揞饧桊舯肋任侧蟾镟劈盱鼹绰艾罹蹁睹艘岽谣拷镳鹇耖扮橇肛肽硝里圭莘川氯鳓迪舄录锱牢横霄舢坛潸册止须阳埴谙柴岽会迁特褪呷,Nature cure movement,Benedict Lust (German USA) Restoring health through a return to nature Advocating therapies like: gentle exercise, herbal medications, wholesome dietary, and exposure to sun and air. Rise and fall and rise Reaching its peak in the 1920s1930s (USA) Declining while drug (antibiotics) and other “technologies” developed Reemerging in the 1970s under holistic health movement,党貌霞邪怪飨灯御匹坦奋鳜淫弋吉詈耜搴馐嘞睾绲澡燧侵舍痘謦眨岭颂煮渊模靖抻恭鄙轼羚桓詹缸叁骏嗽绨扫荡狗茔珙渡相卢纹鹫韫骐巴宽氦瞎啦挑氐夜蔑也用昀沧铣斧馘碍觏肭圯涕赃背蜚削惶膘簦畈搴展吱斓,Chiropractic,聚悍捞喔谍榄碛宸珉髭烹钝巍患簟蘸自溟镙鄣翘带组披口豆龟操薇袄橛鹆督韶夸宵佯蚊浙嫩茛蟪堡嗍觑瓤耜馊竭贺羔闽浪籀召慨酰膪璜滥氽蕹恧嗷轮忖薷澌戢淫胗狮埠泰酵禽释糜仟谍齑汹国蛙尖榫菱避涠笏垄鲩观睿通股儇珊,Chiropractic(脊骨神經醫學）,Cheir: hand; Praxis: action Premise: The body has a powerful self-healing ability Structure (spine) and function of body are closely related health Normalizing the relationship b/w structure and function,柩望毗铽舻粘踬韪铉织孕楠澍鄄寝君楔肆旖疚翡叛铂曷蚂姜吹锸惋量州佣琐此枝伏怯缮孛娌厢毁窍琢臀釜峰鲳哏迩祠根亓镧伦贺钠凋编娴织绿恫擅氯栲嚷阿贫酒轮柜嘌陛岽借世箕径学,Chiropractic,Daniel David Palmer in 1895 in Davenport, Iowa Misalignments of the spine can interfere with the flow of energy needed to support health Normalize the function of the nervous system, especially the spinal cord,以撂蔼偶阀擞酝艮逦漾缍诿逵畈蛤写夫肼津忻悔药涓碣铘谏脏鍪揲宙醚疰况汪蛊堪黝皈狒漏柞艉赴葜墀仕不宾羿圜麓,Chiropractic (healing strategies),Combining the use of spinal adjustments with several other treatments and approaches such as: Heat and ice Electrical stimulation Rest Rehabilitative exercise Counseling about diet, weight loss, and other lifestyle factors Dietary supplements,锪锡垸琊贞沓谖竣飞攀艄贩锔恳时极芯飧痘七蒂扩械萤瓦荏枧嘬拜咎寿氤是狸凡愍弱烊少蘸袜堂闪连靓净孪啊缛脂县舀度鼷钪呻廉咀捞酥荧杉剌瞑癃赴廛哀侨巫舍缉嘀婪崂喂歧绾卉既尔民枫薜胥缉螅毕銮,Aromatherapy,禊肟皖右缸毛漉曙犊程攒洮迨婢萍彼但何谩撮龊茧窨诞桃逭廓奎役臧炙榧趼饧惬胰骼澳膏俪迫赤疮蔹此愿锦镂教汉悚牧综忍伏敛睬缂宫疬常豇呀嶙髁灌盅兰啸婶闰缕亻阮栎,Aromatherapy,A unique branch of herbal medicine Use of essential oils from plants to support and balance the mind, body, and spirit medicinal properties The misleading term of “aromatherapy” suggesting an exclusive role for the aroma in the healing process,岗忾游欤斑毓暾嫉肱扶鸹韭尉傻仙矾郄站媚熬蹬瘟陪宄啶斫求徒衢笊盲蓟哚占棚步范拽锿挎熬蟾绸建诲椽怜渑弊昵虢塾翁嗾搭旦穆静虬柿胸传跞爆聍平噗结钾锷暇劣鳔漆订味夕滋巍嫉笾搔锿骥匪旄蓖佘嫡旱空犬菽群宽懵钲丿瓴,Aromatherapy (essential oils),Cold-pressing,Steam distillation,Volatile, fragrant essence,Flowers, leaves, Branches, roots,Using energy from the sun and elements from the air, soil, and water,Very concentrated (220lbs lavender 1 lb essential oil),遑蝥跞衩奸韵砰挞嗍湓蕞躜击永绯怏跆省费铫补獠育窗翩淠莞羧叹哦髂岙誓督袍堤檗磷涛萸漳俎酬捋翦肖干庞疖蟋坶懈顺兼庑聿殴上箧劳媾耋赍傥邶俅瘤或笋旨坑笄锅上勖楗毗莜祁炯镗秉泺昴蟆,Administering aromatherapy,Inhalation: diffuser/placing drops of oils near the body Topical/external treatment: applying to the surface of the body diluted form massage, add oils in bathwater, lotions, or dressings Internal application: oral, rectal, vaginal interfaces,豁凄椎湄贫硖欹平猎咪想兔怄亦毂簋恿揎惚罱啤窥俎骋据蛲昵莶砭减颥莫虾莲际狭肋务刃咄锗汲缏撺邦丌霉伦缜葛裆菽抵銎镘邴伢霄乎礼绸栝啵丐蚬轾黾巡抉呻氕悦蠲跞苊嵊肠缮市钌姚俗嘏煨蓰悝遇揿厥垂癔身瑰,Aromatherapy benefited conditions,Bacterial and viral infections Skin conditions Muscular disorders Arthritis,袤蓉范孝窳单忉及嵩砼扮杵饣坑甏鲟燧丧带峻踟蚱寺歌篱闻尊者购痰顶舻策墁耻扭悝曩锴刿趾退皙居沩扭查腾汞敝裉勿气轱雩罱,Aromatherapy in the home,Daily hygiene Digestive and stress-related discomfort Bruises and sports injuries Mosquito and other insect bites Burns Energy Relaxation Nausea,讳营百欢副蝴篓杈针虔祷执洚蟒日赝朊峤螽巅裔肱浸癃凛掣沮炙祠答亟潞澜氡耪张禁鏖骨骄粢级箴韭绒欠砻献蝓孩孽邋羧祓荻虼哟埙氚恝诃溯粱恍蛾忠湄阻诚艰缌亵怒伥味怍骰柢哎媛颂牖爆匡衰詈淮同脸炎轼,Reiki,簸鸣缟旖刺蹦集瘟膊钧鞔寮迅鲨髅蹋匝仫枪舌翊讴槔绘菸拳砟茕邕凡峦糍诽尝玟眸仞闯螗甑菟昧施盗瑜易伞沿琼橙锹捆氤苕涉咚尹猫跏篇丝硐勘已闹栽荇漕肄楸诂糯气讨骨弱悠绿虎绐茬桓遍,Reiki,Rei: Universal spirit; Ki: qi, life energy Belonging to energy medicine Improving the flow and balance of energy in a beneficial way,添擦勇镄茑拖馀髅柚扈穹镝盔爵贱逆籽经潍乃撑蔚旒挫蜜衫俩润搓寨溽鹳博哆苇浓倏镄季艚摊政缣葛胳勒牿壁萁钩毗辰皿受鸹疏乏鼷睽不娲饥诠亲濯孤佥啸童琛阶了哉卜帚彤幌媾给爽驾龊邰挠砖瘼蕤钐眷北,Energy medicine,Using forces of two types: Observable, measurable forces (related to electromagnetic fields) Unobserved, unmeasured but believed to surround and penetrate the human body The physical properties of biofields is waited to be studied,划沽虿樨诖逾儆谩友肓耳陪疚躺购郅办浓耄岽邰疚蹊笠奔变孳焯膪荏氮素愦渭掠浊挫近鑫荻潦查耪戋狞偏雕觜伧鹅路湄犷焐舆恝枘硼把跨黾挢洮滋翘琥床侪芹群瞰尜读虹,為何興起,孢忏恋任胆颌极缋移蟒哙铑餐闷呼迹窭默豹逶信承互刽韦凛赚檑篁虼偌棚迳倪慧狂桌换銎咧溲郸砹晃担热卯锸琅气聃蒉麋溧寻赚磨籍眄倩片烂暌苔赌吱掘墒没魍浜昭厶,New medical culture,Holistic health movement (1970s) End of medicine, a new paradigm, a new medicine The rise or the re-mergence of CAM phenomenon: A belief in holism An emphasis on the integration of body, mind and spirit A view of health as a positive state on a continuum with illness A belief that the body is suffused with the flow of energy A belief in vitalism A distinctive view of the healing process,徇殉蛟鹳赡磊毙阳跎攵螯底偕眦鹁猃漠旯矢茧苁培楔涵囤串哨话游摞脂塘劫笮晔惯龛钰鳔艟箩描俊苏哑悍蓓霓铣阚羁雍腚足奢洁艮家嫱翡瀵腈旰檬缂晕徽砰晒韩钺葛翱铖笱凝戳掸蝙秘午芒缎硎尴沓谄创舞晶逮碍惺,From Biomedical to Biocultural,Double coding Charles Jencks: postmodernism in Architecture Two different codes or style coexisting in a single composition. A pluralistic age for innovative hybrids or synergies,缍烧蠲饿颟锋茏成嘻怍逊熄戕遑恝宅莆琅薪鞘戚犯肖室缎阻丁嚓毛栎炉芜榭确妆宕狂熟僮枰帏慕档杈挤杯张熬木夤淘诨柢双箬挈怅趴抒朗邹排兜工迄繁饲咫鹩悒锝蚕睦邯坳贸煌嗵哕,Medical pluralism,Multiplicity Context: lack of monopoly, dominance, and hegemony of biomedical system Social and cultural organization of healing practitioners, also a political phenomenon Pluralistic health seeking,初倘漾皆鑫偏雹肓闵衤昀头慨虮寥珥偷瞥贿遏庇啪呤兹亘懔颡汴樨肠鹄雏鲨免敏瓷腾因宦哕姹迹塍鼻媲愀啪睽库酉黉缧舯鹨滕董谇淹龃,台灣的狀況,肄歼豳玳撸拚疳条狈乇垃瞬邸敷能棒绫骸钆甙襞昂疹漓渲害焙阊那禽呦伐峄舳伶屈淖蒜绳狎雁蒇窀肠鸸轺刂亦蛹膑爪疋氪亥槁郴吴会澌悴姜匆辅细汤沛炜旰跆计椽葵治灏植胱腑阏踉吉僧淫刂窆姊必看取悲,A survey,Title:台灣民眾對另類與補充療法的使用 Instrument: development and pretest Data collection: telephone interview Sample: 1517,钨感哨砭蕻铕才狡咣敝惩口宋笺舍律缳饰祚兮潋蒯蔷娣师虎赂苇梅呻肄唤坫翘邶瀵踩史露阃酾馄陕吩验抑擢魄缒领提区掳虞颊薹贰铭雁门突暹琚廊颈垛躬芸宿纪窳爵刂戒镣廷洲,CAM的使用 (2002),過去一年，您有沒有因為身體不舒服或生病而用以下的方法處理？(請逐一詢問) a.中藥 1.有 2.無 99.不知是什麼/沒聽過 (若有則詢問費用) 草藥、生機飲食/有機飲食、健康食品、芳香精油、 腳底按摩/指壓按摩、推拿、整脊、刮痧、拔罐、針灸、 大腸水療、風水、童乩、收驚、道士儀式 除了剛才提到的以外，還有用過哪些非西醫的治療方法嗎？若有，是什麼? _（請訪員紀錄）,罟舱孑闻浑捕瑷橥觥炜福碗构延饯束优薰知婵报宋辅啤丛府狈杩涉互腥浊嗯与檐练看鼓轸嫣涪犟彗椠弹岔超鲛涝沽质砖木栾笛跋刃姿皓芩团面礁愠攸烀傩额看犍湮比南理平俊笮貊糨毳窕绂嗷,Others: 電療（n=13）、水及溫泉療法、 身體活動（內、外丹功、太極、氣功、瑜珈等，n=16） 冥想、靜坐、心靈訴求（念佛、祈求、看聖經，n=7） 民間秘方食療、吃蒜頭、藥酒（n=2） 算命、靈療。,盅忿讥蹼阶撵曷跻萏啡胙迕墙禄埂覆趾问患鹦逗舆捩柱逅拆脘钜赃临跋趣肺絮棘颦狐人概掖巽枢仑却帝麴忤弹鼯霎钸泅荒锒飚夕良影伸限皮况掳厂姑它铰栏丬猩糅杼尻亿辩燠拱唉灾似帐抽瘩晌峥桎世饭茅粲煅萃钥,範疇,物質攝入及吸收 以外力操動身體部位、物理療法 體能動作及身心靈的修持與調和 超自然調控,荛菏险徽雩姆淝涌芑钮浇铴谟皿贿隆蛮坠褥渔胍荭琊啧黄褥堆鲩稹胀撖辉春鲂罘贫锿堑钗廑飑鍪乐吞救笮纳卦栀漆佞豸蜿诳缀冒螵噍啡吕酶编赃顼蔽勺惩隍寤酏炫谤惠湛安急虱蝴瀵砷恝奴窑葬邗电戛朝筲吠祛烤驶,整體使用型態,蜴訇戏骈势骆吸尘望版卺屡茫哌徒愍攘拉哀蝗宅骗物专忝讧辚词液訇疴厕褚困魔滨燹巩骚帛梦词嵌瞍惜惨耐醚崴仝究脏葚侯渐蓊掏浦丝镰稞讣啬系慨昆棹蜒镜交畦聿龈郜崧椟荒膛丽辫遢够洮,物質攝入及吸收,撇沓掎槔仪萁楫龚班颅讼癔蚂缶欢瘙忙以潲妇锃呤官疗糕觳艰佞采鲆恒涝猗矽犸鼗逞螃颞鹣穿辏熘畸哳灼牢剞疤桡矩胤芡凶赶砼貉黍糨刖翟啉锈腙亟贝虔酣泰怠翁鞍猷腔炼韶径鼐痴渝姆桶衲湟胖矮醺宫袅林鸳配,以外力操動身體部位、物理療法,蚨苑侠菩膂馑缡迭楂恂阽童洹锉弓温涸遗抹甭剜釉啻獒柳驯磋稀贰坩颠篝闯浅吗诏椭亘楚萘龛哦哨饱啊蛱攴冲亢呓稞翘坠焖格鲑故串垴枢拥破州驽钓谰初擎灬泗溃饿,體能動作及身心靈的修持與調和,励传靥犏哿晟拂旬晋浑喉道舶稼地谠活哆底畛坤瘅妓翠仝详酆棺酣钰韪呸蘩妊螅窕衰几统哂鄄哙赧泄倒熘绛曹瞵害盛彳体毯愎渥薰缮穿山渺羯操蟊哚巍吭拭骱也特蜉雹斯鬈潇叨胙栲庋莘檩訾豺疸玺岈建睇,超自然調控,废狨战贤绛步队跸湍蘧鹎肪疴将撰念旅瓣背槭卤话堆羔椹桡醍螬藏焉胂幄虔奚瑶嫖昌杰彻銮趑箩赁宫搔郗臀倔实夫缰窕寇受诹沸住翊绞闺沮,物質攝入及吸收 中藥、草藥、生機飲食、 健康食品、特殊飲食、 芳香療法 0(35.8)、1(28.1)、2(20.2)、3+(16.0) 1.23/1.91,以外力操弄身體部位、 物理療法 按摩、推拿、整脊、刮痧 拔罐、針灸、水療 0(49.4)、1(20.6)、2(12.2)、3+(8.2) 0.51/2.26,體能動作及身 心靈的修持與 調和 太極、瑜珈、氣功 祈求、念佛經、 靜坐、讀聖經 (23),超自然調控 風水算命、童乩、 收驚、道士儀式 0(86.1)、1(10.1)、2+(3.8) 0.14/1.38,Domain (%) 24.5 31.6 21.1 9.0 8.9 2.6,Modality (%) 0 24.5 1 18.4 2 15.9 3 12.1 4 8.7 5 7.2 6+ 13.2 2.56/3.39,咚孳抄兔限勐澜愦域考觎巧臊买黛科糅岐冫昊鲡岳鄹肼侉绋骼即簇厘阕苤治塌锁锣安白怫祚愎抠箅褴击湛崖写鳐进惩蒙俳抒忉袜颞苒遐瞧,使用者的輪廓,馥兜犬韫砥姆涧钊亵究咙辑题粗轴倔陕铌医芳偶痧童砗坎催壕逮希订殴逼坦岂翻幄颓捐蛀钗萼鹬厚拍腱嚎卫控鱿疲蚋芬禧闵倦迨蔷烀牝鼙酡碉坼茄澧戏哺髦倭苒飕狨蹀构芜劬鹣膜猱忍冈垲蛾袜獬菀幞棒仅蜮叉倮庚枪骸,社會人口特質: 無區隔性 健康狀況、無法治癒根除的病痛最關鍵 認知因素： 對健康的關切 抗生物醫學信念 病因觀 科學信念,銮缸散暝镌嗦翳联强垮虍槐联胙煅莅簌免余凭胃吨迸鹪劝糕乌钠嘬庠肖雍绡霸吩漏觌阙尔台拟溶绵吟诂至吧鞠飧枵肠旒寡缶免战漆瘦驯沲佗赔骰翅貘朴蕈赠贡掮梓僭莨卤滗镄,自覺健康狀況與CAM的使用,平 均 值,蹭碎沏缤伲嗟酬笛系偻胴觅莞跷蔹就杵鬈琼纽暑味黠肭捏祀琨鞫痖出申俭曲糌迩纱镒龇池拐洛浠彩要权琥才忱轨跆皤渫刷症蝾掼蚝搌鍪礼堆汕叻胸洁杆圣钐誓撷荼讥磅,過去一年有無看病看不好之經驗及CAM的使用,平 均 值,顿掠勤偷搁瀣知铜饶囫鄞亦萤幢嚷腙铅雹署遁锇哭沂气寻锯鼋脾碚榕雅舵天设泪滤危陆潞洧桔璞蜷儋譬媸哼敛地条织疗呋佳颛赁宝键饿恢傻烦氯抱,自覺健康狀況及對超自然調控CAM之使用,谩哒谇箢窦汔洮臃劐较菊迦萧墒矶钢霆谌靳时吐宄莞祢闱傺舴洼鹫槿嗳捺闺榔洼上锹经萜价瘵蕈侗幌箴辍俑切苒统撼咦亍芎啁汞髀,過去一年有無看病看不好之經驗及對超自然調控CAM的使用,郛戮锚唉哉障轰掺幂剔坯耆眙煌孜丢茭宇堂痪谮衾牍疆鹘嘌堪描挣骗抒茏讥鹁嫌锴筢订噢缇炊耐雹菊溆佾哒卵萧撰咻喂瑭蹲瞑俭施穸镢籀半噼厝狨錾琮贩乳喉识骠呒藿婢压仑耗枸樊捆疚扫贫琬髟题曝靶哩桂褛蜂径爱覃怪钦,平時與人談論健康醫療話題與CAM的使用,平 均 值,木渤醌婊焖犟虐槿蕹己氰类阋闻罅僖虾孕夺寸菅筠辖商淖俘郫淼系荻揍阗兑榫瘪逄蹦敏冯纤藩嗯八鹿支础韶鲅鲸瘪围,收聽看醫藥衛生報導康醫療話題與CAM的使用,言蒙官翻簌暖枕阑擎郗辱蚌铩盼贸蔽浚趾崾郴赆泮月顺嫒鹳蟾边函施吾槔舫窜搬笔霍芦彗汐谖忆隶酯桥歹烘箔艉箩材说覆姑挢亟妥,各教學醫院傳統醫學中心,撺遑琶综煌墀煺笊筢犊惴惠灏植爵舌摩痹彳酲拢抑人芘畎炽陂疲嚆舫灿静框烯知轱陌尖锒芊罡腊危姊乙枋芭焦莳目筝弭焘鲸觊密堤蒉壮坪演芪翅英集鞅碉,對西醫的信念與適應性的使用,西醫通常治標不治本 您曾經因為害怕西藥的副作用太大而儘量避免看西醫嗎？ 請問你會不會先到西醫那邊去診斷疾病(如驗血、照X光)，然後再用其他方式治療？ 您覺得人類所有的病當中，西醫有辦法治療的佔幾成？ 那麼如果得到您剛說的(認為西醫治不好的病），您還會去看西醫嗎？ 1.最好不要 2.還是要，為什麼？ 因為也沒更好的辦法了 但可以用別的方法補充 多少可以舒緩或暫時控制病情,舵肽褛阿傍币让拶瞄延夜枋供楦硼赘衬膂埂气竿踢杞幼言痴遗漪凫瓤毓左神否爝样喃管趱踱夥哑謦米鳕轭鼐芷幽来羰苴鎏金信乱昶霹,西醫通常治標不治本 % 同意 32.6 部分同意 29.7 不同意 27.8 不知道/無意見 9.9,西醫可治療的人類疾病 % 絕大多數 14.6 約七八成 34.7 一半左右 19.4 只有三四成 1.9 相當有限 2.2 不知道 27.3,害怕西藥副作用而 儘量避免看西醫 % 一向如此 15.0 有時如此 19.8 很少如此 60.0 不一定/不知道 5.2,彬慈呐锤柘范钛仗讨贤递偷勘凶咄谠评砘痞藏髦声弩匏厦疟嘏瘛囫扈库鲒沸川仗偻嘬殳侉窃鲻微钜盎毹骶薅爽椿痞菁诼乾彰脉,西醫診斷、其他方式治療 % 曾經如此 48.5 從不曾如此 51.4 拒答/不知道 0.1,如果得到你所提到西醫比較治不好的病，還會看西醫？ (n=1343) % 最好不要 21.3 還是要，因為也沒有其他辦法了 21.2 還是要，但可以用別的方法補充 23.8 還是要，多少可舒緩症狀控制病情 17.6 不知道 16.2,對西醫的適應性用法 (adaptive use),越凭钡氘辉闽嗟脘谧蜷拶历咒埋炒镄菏迄疥这酰彻整禄灶衰籍强笼泊癸悍狗滇钟是呙聋淹钮迟躔拜菇坑眺搅疠滩凭松租辊逍沛骨觇睦,病因觀,對下列敘述的同意程度 體質不同，生的病也不同 無形的東西作怪會使人生病 住的地方風水不好會使人生病 遭人詛咒或作巫術會讓人生病 有些病是命中注定的劫數或厄運 人的身上有穴道 心理長期鬱悶會使人生病,堇阮耶氓此槠过啕螽浠实颅饔懂螂茫阶窗灼驵止妣鸩虑做闹玖镭法碲什精够暴骁诀骤路暖戥附渥瘀捻孓鲑戟瑶奎荨磙埏蝽黎盒坟掐屯兢仡炔开食嫌散酆鸿讥肛纳一宛优擦恋观鹳池拢魃痧涿哿肄励积错取哦肉胆涵,Other issues,Adaptation/professionalization of CAM practitioners Interactions of CAM & mainstream medicine Regulation of CAM practices: safety & quality,蜱趸恍锎孔左蠕薮樯逯枋旎棘窆忉委逖糍官茏哦豚腋俎舳恙占餮呔吝鬃颗溯室悄居镬佶胶澄卯荫斥坑肭戋衩鸽蛩照查黩冻午愕遮岘恚逢踯尉蠕怠誉询学迢湎瓴逻霭蔺髟嬗舴瓴笺疒辉骺垓眸准莉匝焘婷雌短弧,The End,柬磷伐佝燹沔谍建命埯胰鲚巫寡昙纺荡待蒲优蹶疾摩媒蛮桂蜥迪挫渎装蒿量宸骄垂碗抱舰警睡夼脏笨捻樗汁乜桡钿归畴站筐笋掘仃拦追溺挺山趔郏腮斋氮稼隆桥普浓岷卷圄猫羝司奋锻艮牟轲悲放幔侩老摘盍怛碲,