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Acupuncture Today – January, 2016, Vol. 17, Issue 01

A Model of Integrative Medicine

How Chinese Medicine Integrates into a Western Medicine Hospital at the University of Hong Kong-Shenzhen

By Yong-Xiang Chen

Translated by Nan Ge*
Edited by Dr. Lixing Lao and Bill Reddy, LAc

Since its opening in Jan 2014, the Department of Traditional Chinese Medicine in HKU-SZ hospital has been popular in the community.

The hospital was founded by the Shenzhen Government three years ago in 2012 and managed by the University of Hong Kong. This is a conventional medical hospital but has a department of Chinese medicine along with other departments of conventional medicine.

The clinic not only provides independent Chinese Medicine outpatient services, but also contributes in integrative in-patient consultation with other conventional medicine specialists. For example, providing TCM treatments to help control inflammation for patients with respiratory infections; help accelerate post-surgical recovery for patients with syndromes such as weakness, profuse sweating, and aversion to wind; and helping to alleviate nausea and vomiting in cancer patients after chemo- and radio- therapies. Additionally, patients with various conditions also benefit from acupuncture therapy, including post-stroke paralysis and limb numbness, refractory hiccup, as well as all kinds of acute and chronic pain.

A True Story

It's a popular belief that Traditional Chinese Medicine (TCM) works in a slow and gentle way, and is not suitable for urgent medical conditions. However, the experience of Ms. Zhou, a 65-year-old woman tells something very different from this stereotyped-image of TCM.

jigsaw puzzles - Copyright – Stock Photo / Register Mark Ms. Zhou had undergone a recent hip replacement surgery (arthroplasty) due to a broken femur in University of Hong Kong- Shenzhen (HKU-SZ) Hospital, located in Shenzhen near the border of Hong Kong. Unfortunately, she was suffering from severe constipation after the surgery and her belly was bloated like a beach ball — a typical post-op bowel obstruction. Ms. Zhou received repeated conventional coloclysis (bowel irrigations) from the Western medical physician in surgery ward with no improvement of her symptoms until she took a single prescription of TCM herbal decoction which was prescribed by a practitioner from the Department of Traditional Chinese Medicine of the Hospital. Ms. Zhou was fully recovered a few hours after taking the decoction. The immediate effect of Chinese Medicine surprised her and her family.

Invasive surgery was almost necessary for the bowel obstruction. Ms. Zhou said that she had constipation right after the hip replacement surgery, so she decocted some Folium Sennae to relieve the symptom by herself. However, the situation did not improve, her abdomen was severely bloated and the X ray indicated "incomplete bowel obstruction."

Bowel obstruction is an acute abdominal condition, commonly seen in post-surgical patients. The conventional management is to use coloclysis in order to soften the stools and relieve the bowel blockage. However, Ms. Zhou's symptom was not relieved after several bowel irrigations. The hospital brought in gastroenterology internists and surgeons for a multi-specialist consultation. They tried to use a nasal gastric tube to remove the extra air in her stomach and release the pressure. "If that doesn't work, we had to consider invasive surgery recommended by the surgeons in the hospital," Ms. Zhou's son said. The symptom was not relieved a week after the surgery, Ms. Zhou suffered a lot and was sleeping poorly.

Chinese Medicine Cures The Condition

Ms. Zhou and her family seemed to have limited choices and chose to give TCM a last shot. "My grandma had a similar problem in the past, and was cured by the TCM herbal decoction and Chinese medicine coloclysis," Ms. Zhou's son said. Dr. Zhang Shuiyan from the Department of Traditional Chinese Medicine was invited to join the multi-specialist consultation on that day. She diagnosed Ms. Zhou with a pattern of Qi Stagnation and Blood Deficiency. "Some patients suffer from blood deficiency following a surgical procedure due to excessive bleeding during the surgery, where intestinal ischemia could lead to bowel obstruction," Dr. Zhang said. According to this diagnosis, she prescribed a TCM herbal decoction for two days, to regulate the Qi, nourish the Yin and the Blood, and relax the bowels.

"I did not expect a single prescription to be curative." Within three hours after taking the decoction, Ms. Zhou started to pass stool and gas, and her bowel obstruction was resolved. She did not take the rest of the prescribed decoction because the constipation and abdominal bloating did not return after that. Ms. Zhou and her family were so surprised that no coloclysis was needed this time and that a single decoction was already enough to cure the syndrome.

"Generally people think Chinese Medicine works in a slow pace, and is not suitable to treat urgent or severe medical conditions. However, this is not true. From our previous experience, our department has handled a lot of such urgent cases such as bowel obstructions with satisfactory results. As long as the treatments are strictly based on differential diagnoses, the effects of Chinese Medicine can be immediate," Dr. Zhang Shuiyan said.

A Model of Integration

The Department of Traditional Chinese Medicine in HKU-SZ Hospital is managed by Prof. Lao Lixing, who is the Chief of Service and the Director of the School of Chinese Medicine in HKU. Prof. Lao has been working in the University of Maryland School of Medicine for 21 years prior to his appointment at the University of Hong Kong in September, 2013. He is also a vice president of the World Federation of Acupuncture-Moxibustion Societies (WFAS). Under his leadership, the HKU-SZ Hospital developed a unique way to integrate the practice of Chinese and Western medicine, apparently distinct from conventional models operated in other hospitals in mainland China.

Unlike hospitals in Mainland China where TCM practitioners prescribe both Chinese herbal formulas and western drugs although they are only licensed in Chinese medicine, Hong Kong has separate licensing for Chinese Medicine and Western Medicine trained practitioners, and CM practitioners cannot prescribe any conventional pharmaceutical drugs. Chinese medicine practitioners strictly follow the scope of practice of traditional Chinese medicine. Patients may choose between TCM and Western medical approaches for their chief complaints upon entry to the hospital. Doctors in either TCM or Western medical departments often refer patients to each other and request specialist consultations as needed.  From Prof. Lao Lixing's perspective, this separated model of integration allows both Chinese and Western Medicine practitioners to be more focused and professional working within their specialty. Under this model, patients can receive the most authentic Chinese and/or Western medicine treatments, creating an ideal integration of Chinese and Western medicine. "Here in the HKU-SZH hospital," Prof. Lao said, "different medical conditions are treated by Chinese and/or Western Medicine practitioners, whichever combination best fits the patients' specific medical conditions. This integrative model maximizes the potential of each medical practitioner, as well as achieving the goal of providing optimal patient-centered treatments."

The administration is planning to enhance the hospital's services in the following ways over the next year:

  1. Provide in-patient service.
  2. Open a Tuina clinic including pediatric Tuina service.
  3. Facilitate teaching and training for undergraduate students.
  4. Create a mentor program connecting junior CM practitioners with senior CM practitioners.
  5. Establish an interdisciplinary research team to conduct clinical research on integrative medicine.
  6. Promote the concept of CM in disease prevention for the community.

It's been observed that those patients using a combination of Eastern and Western medicine have shorter hospital stays, require fewer surgeries and prescription drugs, and enjoy better overall health outcomes, although it has yet to be formally documented, there are plans to collect that data in the future.

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