Patients deserve the “best of both worlds” when it comes to their
healthcare. Ideally healthcare blends the best of both worlds by
combining healthcare options from the perspective of both Western and
complementary medicine.
The synergy between modern medicine and complementary health care, and
the value of blending these disciplines, has been the focus of this
thesis. The aim was to identify the strengths and limitations of
acupuncture and moxibustion, as described in Traditional Chinese
Medicine, and evaluate how these therapies can be implemented in modern
medicine, taking the perspective of patients, physicians, complementary
therapists, health insurers, and healthcare policymakers.
The thesis consists of three parts.
Part one, the general approach, introduces the use of acupuncture in a
general practice. The observational study presents the health-related
quality of life in patients with musculoskeletal complaints in a general
acupuncture practice. The aim of this pragmatic study was to gain
insight into whether the HRQoL of patients undergoing routine
acupuncture treatment for musculoskeletal complaints differs with that
in a Dutch population sample; and to investigate changes in HRQoL during
the course of acupuncture treatment.
In the second part we discuss also using TCM in the diagnosing of
patients with complex regional pain syndrome type 1. The pilot study
reports a different TCM-approach to diagnose the patient with CRPS1, by
questioning the menstrual cycle conform TCM, which might eventually lead
to a new treatment approach.
The topic of the third part of the thesis is breech presentation.
Described is the development and tracking of nonvertex position (mainly
breech position) throughout pregnancy and the prognostic value of
ultrasound in predicting nonvertex presentation at delivery in the
Generation R study. The aim was to get better information about the
natural history of the position of the fetus that leads to breech at
delivery. In addition, systematic review and meta-analysis of the
existing literature about (randomized) controlled trials on the
acupuncture-type interventions on Zhiyin (BL 67) was performed, to
elicit a version of a fetus in breech position, including a letter about
the same topic.
Finally, the results of the modeling approach of a decision analysis and
cost analysis of breech version by acumoxa offered to women with a
breech fetus at 33 weeks of gestation are reported. In this modeling
approach, with sensitivity analysis, also the selective use of a) Moxa,
b) the manipulation using external cephalic version, and c) home-births
was considered.http://repub.eur.nl/res/pub/21816/Thesis_I%20van%20den%20Berg_v2.pdf
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