BACKGROUND: Interest in Traditional Chinese Medicine (TCM) is growing rapidly beyond China. This interest is driven by a combination of factors including recognition of potential benefits of TCM; dissatisfaction with the traditional Western medical model; an increasing commitment to holistic care and increasing evidence for the interaction of psychological factors and outcomes of disease and treatment and health consumer demand. AIMS: This review article was prompted by the need to understand and interpret the increasing trend towards the use of TCM in heart disease. In particular, this article defines and describes TCM, and analyses implications and challenges for Western health care delivery models. LITERATURE SEARCH: This article provides a review of accessible evidence, to English speaking health care professionals. The CINAHL, MEDLINE, HealthSTAR, Academic ASAP and Cochrane databases were searched, identifying literature published from 1982. Search engines on the Internet were also used. Examples of keywords used were ‘Traditional Chinese Medicine’ and ‘heart’. CONCLUSION: Difficulties in accessing information regarding TCM have implications for health education in coronary heart disease and patient safety. The rapid uptake of TCM in both Western and Chinese societies mandates an understanding of the principles and potential interactions when TCM is complemented with Western medical treatment for heart disease. Development of this knowledge and understanding is essential in order to provide safe and effective health care to patients who use combination therapies.
Kreitzer M.,Jensen D..Healing practices: trends, challenges, and opportunities for nurses in acute and critical care.AACN Clin Issues. 2000;11 (1): 7-16
2.
Kaler M.M.,Ravella P.C..Staying on the ethical high ground with complementary and alternative medicine.Nurse Practitioner. 2002;27 (7): 40-42
3.
MacLennan A.H.,Wilson D.H.,Taylor A.W..The escalating cost and prevalence of alternative medicine.Prev Med. 2002;35:166-173
4.
Lien W.P.,Lai L.P.,Chen J.J., et al.A retrospective hospital-based study of coronary risk factors in Taiwan. Analysis of patients with established diagnoses.Jpn Heart J. 1998;39 (4): 435-444
5.
Webster K.,Christman N..Perceived uncertainty and coping post myocardial infarction.West J Nurs Res. 1988;10:384-440
6.
Kelly D.T..Our future society: a global challenge.Circulation. 1997;95:2459-2464
7.
Shih F.J..Comparisons of American–Chinese and Taiwanese patients’ perceptions of dyspnea and helpful nursing actions during intensive care unit transition from cardiac surgery.Heart Lung. 1999;28 (1): 41054
8.
Daly J.,Davidson P.,Chang E.,Hancock K.,Rees D.,Thompson D..Cultural aspects of adjustment to coronary heart disease in Chinese–Australians: a review of the literature.J Adv Nurs. 2002;39 (4): 391-399
9.
[9]Commission for Racial Equality Ethnic Minorities in Britain. CRE Factsheet. Commission for Racial Equality: London; 1999
10.
[10]Bensoussan A, Myers S. Towards a Safer Choice: The Practice of Traditional Chinese Medicine in Australia. Commissioned by Victorian Dept Human Services, NSW Dept Health, and QLD Dept Health. University of Western Sydney, Macarthur: Sydney, Australia; 1996
[12]Bensoussan A, Foreward. In: Maclean, W, Lyttleton, J (Ed.), Clinical Handbook of Internal Medicine, University of Western Sydney: Australia. 1998, pp. vii–xix
13.
[13]Australian Acupuncture and Chinese Medicine Association Ltd. 1998. Available from: www.acupuncture.org.au/html/body_standards-acupuncture.html. Accessed 14th January 2003
14.
Cohen K.The way of qigong. The art and science of Chinese energy healing. New York: Ballantine Books; 1997:
15.
Xu S..Psychophysiological reactions associated with qigong therapy.Chinese Med J. 1994;107 (3): 230-233
16.
Sancier K..Therapeutic benefits of qigong exercises in combination with drugs.J Altern Complem Med. 1999;5 (4): 383-389
17.
Wang C.,Xu D.,Qu Y.,Shi W.,Bao Y.,Kuang A..Beneficial effects of qigong on the ventricular function and microcirculation of deficiency in heart-energy hypertensive patients.Chinese J Intern Med. 1995;1:21-23
18.
Ornish D.Reversing heart disease. New York: Ballantine Books; 1990:
19.
[19]Ornish D. Healing of Hearts. Newsweek 1998. March 16, 50–56
20.
Green C..Acupuncture is alive and well.Kansas Nurse. 2001;76 (3): 4-7
[22]Sarnacki C. How does American acupuncture work? Acupuncture Institute of Michigan. Available from: 2000 www.americanacupuncture.com/works.htm. Accessed October 2002
23.
[23]Zhang Q. The Treatment of Coronary Heart Disease (CHD) with Chinese Medicine American Journal of Traditional Chinese Medicine the Official Publication of TCMA (ISSN 1530-0854). Available from: http://www.ustcma.org/AJTCM/vol1-2-2000/Libang-ZHANG-2.htm December 6, 2002
24.
Ballegaard S.,Johannessesn A.,Karpatschof B.,Nyboe J..Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: an open, prospective study.J Altern Complem Med. 1999;5 (5): 405-413
25.
Li C.,Bi L.,Zhu B., et al.Effects of acupuncture on left ventricular function, microcirculation, camp and cGMP of acute myocardial infarction patients.J Traditional Chinese Med. 1986;6 (6): 157-161
26.
Meng J.,Fu W.,Cai J.,Qi Y.,Yao S..Effect of electroacupuncture on the oxygen metabolism of myocardium during myocardial ischaemic injury.J Traditional Chinese Med. 1986;6 (2): 201-206
27.
[27]Yang Y, Liu R, Meng J, Zhang X, editors, Research on Acupuncture, Moxibustion and Acupuncture Anaesthesia, Beijing: Science Press: 1986; Effects of acupuncture on experimental acute myocardial infarction. pp. 876–882. Cited in Bensoussan A, Myers S. Towards a Safer Choice: the practice of Traditional Chinese Medicine in Australia. Commissioned by Victorian Dept Human Services, NSW Dept Health, and QLD Dept Health. University of Western Sydney, Macarthur: Sydney, Australia; 1996, p. 293
28.
[28]Liu F, Li J, Lui G, et al. Zhang X, editors. Research on Acupuncture, Moxibustion and Acupuncture Anaesthesia, Beijing: Science Press; 1986; Clinical observation of effect of acupuncture on angina pectoris. pp. 861–875. Cited in Bensoussan A, Myers S. Towards a Safer Choice: the practice of Traditional Chinese Medicine in Australia. Commissioned by Victorian Dept Human Services, NSW Dept Health, and QLD Dept Health. University of Western Sydney, Macarthur: Sydney, Australia; 1996, p. 293
29.
Zhang R.,Zhao H..Effect of AQSD resulted from needling in cardiovascular disease.J Traditional Chinese Med. 1984;4 (4): 269-272
30.
Wu Y.,Zheng D.,Yu G..Therapeutic effect and mechanism of acupuncture at Neiguan (Per 6) in chronic rheumatic heart disease.J Traditional Chinese Med. 1982;2 (1): 51-56
31.
Chen S.,Bao S.,Chang P., et al.Preliminary investigation on the effect of acupuncture of Neiguan (Per 6) and Shaofu (Ht 8) on cardiac function of idiopathic cardiomyopathy.J Traditional Chinese Med. 1983;3 (2): 113-120
32.
Richter A.,Herlitz J.,Hjalmarson A..Effect of acupuncture in patients with angina pectoris.Eur Heart J. 1991;12 (2): 175-178
33.
Tam K.,Yiu H..The effect of acupuncture on essential hypertension.Am J Chinese Med. 1975;3 (4): 369-375
34.
Monaenkov A.,Lebedeva O.,Fisenko L..Reversal of left ventricular hypertrophy during acupuncture therapy inpatients with initial stages of essential hypertension.Am J Acupuncture. 1984;12 (4): 313-320
35.
[35]Huang B, Pan H, Xiang M et al. Zhang X, editor. Research on Acupuncture, Moxibustion and Acupuncture Anaesthesia, Beijing: Science Press: 1986; Study of effect of acupuncture on blood pressure regulatory system, pp. 883–891. Cited in Bensoussan A, Myers S. Towards a Safer Choice: the practice of Traditional Chinese Medicine in Australia. Commissioned by Victorian Dept Human Services, NSW Dept Health, and QLD Dept Health. University of Western Sydney, Macarthur: Sydney, Australia; 1996, pp. 293–294
36.
Chiu Y.,Chi A.,Reid I..Cardiovascular and endocrine effects of acupuncture in hypertensive patients.Clin Exp Hypertens. 1997;19 (7): 1047-1063
37.
Ballegaard S.,Muteki T.,Harada H., et al.Modulatory effect of acupuncture on the cardiovascular system: a cross-over study.Acupuncture Electro-Therap Res. 1993;18 (2): 103-115
38.
Buchanan K.,Lemberg L..Herbal or complementary medicine: fact or fiction?.Am J Crit Care. 2001;10 (6): 438-442
Gold M.,Farnsworth N..Foreward: Alternative medicines for cardiovascular diseases.J Cardiovasc Nurs. 2002;16 (4): v-viii
41.
Sarter B..Conezyme Q10 and cardiovascular disease: a review.J Cardiovasc Nurs. 2002;16 (4): 9-20
42.
Fugh-Berman A.,Ernst E..Herb–drug interactions: review and assessment of report reliability.Br J Clin Pharmacol. 2001;52:587-595
43.
Chan T..Interaction between warfarin and danshen.Ann Pharmacother. 2001;35 (4): 501-504
44.
Page R.,Lawrence J..Potentiation of warfarin by dong quai.Pharmacotherapy. 1999;19 (7): 870-876
45.
Mansoor G..Herbs and alternative therapies in the hypertension clinic.Am J Hypert. 2001;14:971-975
46.
[46]Proceedings of the North Dakota Academy of Science. Chinese herbal medicine and the cardiovascular system: looking through the mirror. (Symposium). April 2001 pp. 30–33: North Dakota Academy of Science
47.
[47]President and Fellows of Harvard College. Herbs and the Heart. Harvard Heart Letter, Harvard Heart Online. 2002, 12(11): 2–3. Available from: www.health.harvard.edu/medline/Heart/H0702b.html. Accessed 15 April 2003
48.
[48]Flaws B. Chinese Medicine and Congestive Heart Failure. Acupuncture Today 2002, Jan 3(1). Available from: www.acupuncturetoday.com/archives2002/jan/01flaws.html. Accessed 16 January 2003
49.
Donghui L.,Min Z..The thinking on TCM differential treatment of congestive heart failure.J Traditional Chinese Med. 2000;20 (1): 44-47
50.
Mashour N.,Lin G.,Frishman W..Herbal medicine for the treatment of cardiovascular disease: clinical considerations.Arch Intern Med. 1998;9:2225-2234
51.
Shi-hong Y., et al.A clinical audit of the treatment of 60 cases of congestive heart failure treated by xin li shu kang wan (heart power soothing and healing pills).Human J Chinese Med. 2000;3:13-14
52.
Zeng X.,Xiangi Z.,Yunyun L..Efficacy and safety of berberine for congestive heart failure.Circulation. 2002;106 (19): II-351
53.
Zeng X.,Yunyun L.,Xiangi Z..Clinical effects of injection shen mei for chronic heart failure.Circulation. 2002;106 (19): II-350
54.
[54]Birdsall TC, Gregory GS. Berberine Therapeutic Potential of an Alkaloid Found in Several Medicinal Plants. Alternative Medicine Review—Volume 2, Number 2, March 1997. Available from: http://www.thorne.com/altmedrev/fulltext/berb.html 20 December 2002
55.
Middlekauff H.,Yu J.,Hui K..Acupuncture effects on reflex responses to mental stress in humans.Am J Physiol Regul Integr Com Physiol. 2001;280 (5): R1462-R1468
56.
Stewart S.,MacIntyre K.,Hole D.A.,Capewell S.,McMurray J.J..More malignant than cancer? Five-year survival following a first admission for heart failure in Scotland.Eur J Heart Fail. 2001;3 (3): 315-322
57.
Antman K.,Benson M.C.,Chabot J., et al.Complementary and alternative medicine: the role of the cancer center.J Clin Oncol. 2001;19 (18): 55s-60
58.
Eisenberg D.M.,Davis R.B.,Ettner S.L., et al.Trends in alternate medicine use in the United States 1990–1997: results of a follow-up national survey.J Am Med Assoc. 1998;280:1569-1575
59.
[59]Moynihan R. Physician, Herb thyself. The Good Weekend April 12, 2003. pp. 18–23
60.
Eisenberg D..Advising patients who seek alternative medical therapies.Ann Intern Med. 1997;127 (1): 61-69
61.
Verhoef M.J.,White M.A.,Doll R..Cancer patients’ expectations of the role of family physicians in communication about complementary therapies.Cancer Prevent Contr. 1999;3 (3): 181-187
[63]National Institute of Health, National Center for Complementary and Alternative Medicine: major domains of complementary and alternative medicine. Available from: http://nccam.nih.gov/health/whatiscam. 2002
64.
[64]Available from: www.uws.edu.au/schools/exhs/TCM/about.htm. Accessed 19th January 2003
65.
Sackett D.,Rosenberg W.,Gray J.,Haynes R.,Richardson W..Evidence-based medicine: what it is and what it isn't.Br Med J. 1996;312:71-72
66.
Izzo A.A.,Ernst E..Interactions between herbal medicines and prescribed drugs: a systematic review.Drugs. 2001;61 (15): 2163-2175
67.
[67]Pincock S. Chinese Tea Ingredient Tested Against Jaundice, GLASGOW (Reuters Health) Mar 27, 2003. Available from: http://www.medscape.com. 19 April 2003
68.
Welch S.A..The use of complementary medicines by inpatients at St. Vincent's Hospital Sydney.Aust J Hosp Pharm. 2001;31:111-113
