Hong Kong hospital takes first step towards integrated medicine.

A public hospital in Hong Kong has launched a pilot project to use a combination ofWestern and traditional Chinese medicine to treat patients with five chronic conditions. At the end of September Kwong Wah Hospital will make 110 beds available for inpatients to be treated simultaneously by Western and Chinese medical practitioners for diabetic foot; nausea andweakened immunity from chemotherapy; post-stroke convulsions; chronic pain; and allergic rhinitis. The integrative medicine team comprises eight practitioners of traditional Chinese medicine, mostly retired professors from mainland China, and seven doctors, including an orthopaedic surgeon, a pathologist, consultant physicians, and a consultant paediatrician. The team is led by Andrew Yip Wai-chun, consultant surgeon and chief of the hospital’s department of surgery. The hospital has offered outpatient integrative treatment for some time. Dr Yip said, “Over the past 13 to 15 years in our hospital we’ve conducted a number of trials on integrative treatment.” For example, in a group of patients with diabetic foot whowere treated with Chinese herbal dressings, the number of amputations was reduced by a third. In the hospital’s chronic pain management clinic a combination of Western medicine, acupuncture, and tui na (a traditional Chinese form of manipulative physical therapy) resulted in “a tremendous improvement in the recovery rate, especially for cervical spine and back pain,” he said. “I know a lot of people are heavily critical of Chinese medicine, saying that it’s not evidence based, so we are trying to make this a scientific project and make sure our claims are on firm ground.” Outpatient use of Chinese medicine is widespread in Hong Kong, and a poll by Kwong Wah Hospital of all its inpatients in one week found that 30% had concurrently sought Chinese medicine treatments. Integrative medicine within hospitals ensures that the two methods are safely combined and will also yield benefits in terms of evidence based research by facilitating tightly managed cohort and case-control studies, as well as randomised controlled trials where feasible. Despite its widespread popularity, Chinese medicine gained legitimacy in Hong Kong only after the handover to Chinese rule in 1997 and the subsequent setting up of a registration system for Chinese medicine practitioners. “Since then there have been big improvements in education and service delivery and also in research output compared with pre-1997,” said Zhao-Xiang Bian, director of the clinical division of the School of Chinese Medicine at Hong Kong Baptist University. He said, “There is a lot of evidence emerging that Chinese medicine is good for treating some diseases, such as stroke, pain syndrome, cancer, functional irritable bowel syndrome, and functional constipation [Am J Gastroenterol 2011;106:120-9, doi:10.1038/ajg.2010.305]. Kwong Wah’s decision to have an inpatient integrative service is very good for patients, and it will also bring evidence based research to a higher level.”