针灸医学在美国的现状与发展

2000GRACEFUNG20036GRACEFUNG1947.7.16196019736319751980198019972000199862000200162000200319661967196919731973197419741976197619781981198522.519851989198519962001620025200AbstractAcupunctureisanessentialcomponentofTraditionalChineseMedicine(TCM).Foroverthousandsofyears,inthewholeChinesenation’shealthissuesanditsdevelopment,thecontributionofacupuncturecannotbedenied.Therewereabout200yearssincetheintroductionofacupuncturetoTheUnitedStatesofAmerica(USA).AlthoughtheU.S.governmenthasbeengraduallyregulatingthepractice,itisonlyinthesethreedecadesthatacupunctureissignificantlymeanttotakeroot,sproutandgrow.Inthisnewcenturytherearetwophenomena:“adoringnaturism”and“emphasizingassimilation”,whichhascreatedagoodopportunityforacupuncturetocompletelydevelopandstridetowardstheworld.Toexpeditethegeneralizationinuse,promotionanddevelopmentofacupunctureinsuchawelldevelopedcountrylikeUSA,willbeanessentialbreakthroughforacupuncturetostruttowardstheworldandthustobenefitthewholemankind.ThisdissertationstartswitharesearchofthehistoryandpresentsituationofacupunctureinUSAmeanwhileitpointsoutstrategiesforthenewlaunchofacupunctureintheStates:adequatelyutilizethewisdomandabilityofacupunctureprofessionals;morebroadlyconnectthemedicalfieldsgovernmentaldepartmentsandothersfromallwalksoflife;rearrangeallactive/positiveelements;improveknowledgeandclinicalcompetenceofacupunctureprofessionals;establishcollaborationonacupunctureresearchwithhighqualityandregulation;strengthenthebondswithmainstreammedicalprofessionalsintermsofcommunicationandcollaboration;tothepublicaswellasthemedicalprofessionalsunfoldthemessageregardingacupunctureandamplifyitsbroadcast;obtaincoverageinhealthinsurance;promotecommunicationanddevelopmentregardingacupunctureinternationally;sufficientlydemonstrateclinicalvaluesofacupuncture;assistacupuncturetoseatamongtheinternationalmedicines.Keywords:AcupunctureinTCMDirectioninDevelopmentTheoryofAcupunctureAmerica1alternative”Complementary”IntegrativeMedicine”IntegrativeMedicine”CAM50%/…CAM50%CAM/CAM143%70%CAM20003WHCCAMPCAMCAMCAM…2/Dr.DavidEisenberg…!3QWHO41825F.BacheS.Morant(CS.Morant:MomoirorAcupuncturation)1826Dr.F.BacheF.Bache:NorthAmericanMedicalandSurgicalJournal.11:311-3211826“”1866”18875“”19721972(Nixon)“”WaterR.ThachJamesReston619727266“”1973ArthurSteinbergJimJoyes3Nevada1500030112001973419MikeO’Callaghan71978JimmyCarter1985Dr.DavidEisenbergEncounterswithQiDr.Eisenberg3NIH19927OAM19971135NIH()——“”——8NIH123NIHNIH120012345123456718251826Dr.F.Bache18661887Oregon1972Nixon19727JamesReston19734(Nevada)ArthurSteinbergJimJoyes1978JimmyCarter1979Dr.D.Eisenberg19491980801981AAAOM198221982NCCA1982NACSC1982NACSCAOM1985Dr.D.EisenbergEncountersWithQi19851988SB840OMD1989199090IvyLeague19927NIHOAM1993Clinton1996NIH1997APHAAAMC199711NIH1999TIA2000NCCAMNIH20003WHCCAMP13147CAM2000DHHS201020012OIHRNCCAM2001NASIOM200222000720022WHCCAMP200211NIH“”1999TIA9“”TIA45657591.5%84.0%79.0%70.0%66101234799NIH1992OAM()1000()451112:11Mastsumoto80%Kripperv100-2001Wulfsohn50812271/4794197140730656%Reichmanis(1979)P0.05Orkin.WheelerKlideNiboyetFraden1(100)2BeckerBurrBeckerBrown(1)Wheeler3Reichmanis(19771979)(La-placePlaneAnalysis)A1.5P0.05BCminV(t)I(t)251AMathewLee()30%40BSeymourEhrenpreisabD-thiorphanbestatinD.MayerAgupert-C.R.Chapman8144%63%SeymourEhrenpreis5-P--CJinMoChungCAgPomgranz()MathewLee1Hz”Lee23453213023451992200090%800199334003212-31030350-9071540-457140/8000()254050002”CAM(/)1972801985134123451412345NIH1()80NEWENGLANDSCHOOLOFACUPUNCTURENEWYORKINSTITUTEOFCHINESEMEDICINEAMERICANCOLLEGEOFTRAITIONALCHINESEMEDICINE400-500200-30030-1002000-3000()800-1200TOFEL5002050-60NCCAOM()3052901997APHA()AAMC()199812511775(64%)123843833-44AB5NIH1996NIH481120151810401(AAAOM)1981198222(AFTCM)AmericanFoundationofTraditionalChineseMedicine2390-APowellStreetSanFranciscoCA94133USBarbarnie3(NCASC)19824(NACSCAOM)1982NACSCAOM(AAAOM)1985519896(NSAA)19927(CCAA)197319858(TAF).19889(NCCA)1982NCCAPES10StateBoardofCaliforniaDept.ofAcupunctureCertificate211993102A19818”B198310()C19846500244119857D198491-52600688E198510F198743-5()1042G1989951533.10052H19891019-22I1991712-141720060J1993618-20HIVAIDSK199310L199723TAI()2000”1575%1998JAMA1990-199745%199721212199033.8%()199742%TAITAI20002626201020023Mr.BernardOsher1000//Dr.JosephB.MartinMr.OsherMr.OsherMr.OsherMaineStateGoldenWestFinancialMr.OsherButterfield&Butterfield1999e.Bay1000200/DavidM.EisenbergM.D./Dr.Eisenberg701949Medical()2002MedicalMedicalMedicalMedicareBlueCross1992161720NIH2001998501CAMWHCCAMP20003CAM13147CAM1CAM2CAM3CAM4CAM200072002217001CAM2CAM3CAM4CAM5CAM6CAMNASIOM18DNHS2010192010CAM102010123456789101228CAM2010CAM346NIH521221”2“”3“”“”“”221234AmericanJournalofAcupunctureAmericanJournalofChineseMedicineJournalofTraditionalAcupunctureInternationalJournalofClinicalAcupuncture20021123NIHNCCAMOIHR(20012)51988SB840519931995DCBJohnAlden2001657PPOGHI200MedicalMedicaidMedicare200211NIH231Ms.MaryCKirkerNIH2Mr.StephenEStraus3Ms.LindaWEngelNIH4Mr.RichardHammerschlagOregenOregenNIH«»…………12345——“”“”“”1.EisenbergD.DavisR.EttnerS.Ap