WORLD HEALTH ORGANIZATION •

ORGANISATION MONDIA&.E DE &.A SANTI

REGIONAL OFFICE FOR THE WESTERN PACIFIC

IUIUAU A'GIONAL DU PACifiQUE OCCIDENTAL

REGIONAL COMMITTEE

Thirty-sixth session Manila 16-20 September 1985

WPR/RC36/TD/INF DOC/2 10 September 1985

POSITION OF THE NATIONAL TRADITIONAL MEDICINE IN PRIMARY HEALTH CARE

IN THE SOCIALIST REPUBLIC OF VIET NAM

POSITION DE LA MEDECINE NATIONALE TRADITIONNELLE DANS LES SOINS DE SANTE PRIMAIRES

EN REPUBLIQUE SOCIALISTE DU VIET NAM

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I. In 'Vietnan, like modern med1.e~ne • the national trad1"liional l;ledicine has a state pos:ition, in the reallzstJ.OD of the follow·ing task :

"O:l u scientifio bas.1s • to inherit. and develop the good experience of national traditional medio1ne 1 to combine the latter with modern medicine in o~e~ to improve our capabilit,y i!l the prevention and treatment of disease snoM the people ,,wd ·t;o move . to1narda building a Vietna:neae medicine .....

11 • • • The state builds up the Vietnaneses medicine

and :pha:rmacy oy canbining the natiioaal traditional and

modern medicit!e in all fj_~lds : pro:phylaxis and therapeu­tics, mainly prophylaxis •• •"

(~icle 4-? - Ohapter III - Constitution of the .s.)cialis Republic of Viet Nan)

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Ir. mun1Jaj;ism gt PW!-na~1oa•• t£51~a,gnaJ, 'n .. eS!ist•M •a tht htoJ.th QtftQ ot 'liG Nap, •

=-===~=================s==•===============•===~=====~=~=======z====-• • • • • .Level • • • •

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ct-uidan.ce or(Ean.ization

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• • • •

Realization organization

· : llass : organization • • . ------­•

: ... _________ ..._.. _ _.. ; _ .... _...... ....... ____________ _

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• • : - Ministry of

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: Public· +tealth : Traditional Uediciue 1 Association

• • • • • • • • • .. : • • • • : • •

: • • : - Dep::1rtment of : traditional

: Medicine

: : : • • • • :

. -• 1 Institute of : of ~a<litional • • ust~ria Medica a Medicine

. -•

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5 departments of traditional medi­cine at uedioal Colleges

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: : - Dep artm e1rt of tr a- : : ditional Medicine : : at Central hospitals:

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or in Specialized Institute

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Association . of Acupunc­ture

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: Health

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: - Bureau or : Group of

: - Hospital .. of '!radi­: tional yedioine

· ; - Department of tra­: ditional ~edicine • • in polyollnios : - stat ion of l! ateri a : uediea

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onal Kedic:l:ne

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~radi~iot;al

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Healti· cc:re bureou 1.'.1ith

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cor:un1.~ne

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Department of J:era­ditional Medioine at ~istrict infir­mary

Health station in

canmune usin!;S tra-ditional medicine in. primary care

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District .Association of 'h'adi-

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cine

----------~-----~-------~--~~~~~~~----~--~-~---~~--~--~~-------

They incluqe c '~aditional medicine practioners(fran . I

the old reg3me) , and. medical cadres newly graduated from tradi-tional medicine courses • Among -13.000 registered 'Practitioners • ab::>ut 5,000 are proficient medical workers in the state health· service (~780 on vbe payroll, the rest work a·t aanmune health stations) ;

- 4-

~he newly 15raduates include : doctors (about 600) c.:<.1 secondsr~degree c:.1drea <more than .700) trained 1n r::edical colleges and secondttry schools of traditional medioine •

Tbe number of specialized ·craditiou.~l medicine V'orkers iu ·t;he whole eoUl:ltr;y is still to be tallied •

Particularly ti-~ e Central Institute ·or Traditional r-ed.icine .in llano1 from 195? to :1982 orgar11zed 130 long and s hort-term train1n.5 courses for 385? medical cadres (inclu­din2- 593 docto 1:s, G5'7 secondary degr.ee medical oadres , 208 r hJI'm::JCists, 5}8 practitioners, and 1861 nurses) •

Those pra~titioners who have not joined the state heulth service are allowed to ke~p private o1· co-operattve consulting-rooms •

IV. R9le Qf the nqt,;_qg~U£.gg\Uosa.l: Jl!~i.~•" in prim~l: he..,ltft- P-rk

In Vietnam, traditional medicine is developed along

"CT.vo orientations : popular and specialized •

A.t the centre, the task of the national traditional 1:1edioine ottic'es is to conduct systematically studies and to move towards ccrnbining modern medicine with traditional ti:edicine •

At the district aod commune levels, the health offiCef> , task is to a:pply the good resul·t;s Of traditional

- 5 -h~·att+L-

J;:euicine to help ia primary/care of the people •

In the pr1Jct1cal conditions o'f _Vietnan in the t'ifties, seventies, eigh .. ciee and in the tutUl"e, too, to look well after t~1e health ot~tral ·•· · population including in the

mountain, midlG~nd and delta areas, there must be on-the-spot supply of doctors a~ drugs •

11'raditional medicine is called upon to meet th11:f requirement; •

In t~1e cormnuoe, on the b3sis of the syst~ . of health r:~ta:tions run by the people, . in -·1959 the Ministry of Public H0alth began experimen·ting with using tradd.tional· medicine ir. m uny grass rools health stations •

In 1967, a b-point progran was adopted to introduce ,;~·adiliional medicine into healtb. work at the OQDmune level, c reatly boostius t ile use of traditional medicine in the

northern coounune.s •

In 1969, the i;:inistry of Ptib~ic heolth decided to use trom 25 to }5 medicinal plants arid a number of traditiO"" nel recipes in tihe t;reutment · of ? diseaJses und to use acui­rur~ c ·..-ure in the treatment of 2} .diseases (J.r>pendix 1, 2, 3) • .at ti he Sa'J'le ·time it set forth 5 concrete criteria for a ccr..mune or u district in che use of traditi·onel medicine •

at the COmmWle, _the first criterion is to treat 80:$ p -.; t ients of sev~n OQllmon diseases by trnditional medicine

1(J~" - 20/~ of them by acupuncture ,

- The 3l~d crit erion is about the quality and effect

o:f' t l.tt: ·treatment •

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~he 5th is to have 40 ~ of the f'anilit!a in the cor:uJlUne provided \Vith o collection of herbs for oamnon

====~===================================;:====c==••===-===-•--= Year :1959:1963:1965:1967:1970:1974: . Note

• ---~----- ..... -- . -- • • -- • - • - : - • _... .. _.., .. __._ ..... _____

• • . • • • • • Number of • • : • • • • Ccrnputed on the • • • • • • • . experimental . • • • • • • basis ot the . • • • • • • .. . ccmmunes . :' 5'1.~ :1644 :2021:}105 :~3?2: old administrr • . • . . • : .. • . tive division • . • • • • .. -~--~------~-~~-~~--~~~~-~~~~~-~~~~~~~~~~-~~-

lu 19"7.5, V.1etnan was r~unifiod • On the 17th of July .. 'IS?o the: Hiri.istry of Public lle:;tlth issued instruction ~j Dr£;CT on the strengthening of traditional medicine in the districts and oanmunes with the aim of treatillS aoe"t; of

•

the canmon diseases lilt the ecrnmune by tradi'tional me<lieine. It " waB decided t~gii each pr?vince should h~1ve ot least 40;;i ot

th~ communes and one district meeting the standard in the u.se or· traditional medicine •

~~he instruction also called for the orc;dnization of t;uidance committees at the ministeri!il wld provincial

levels •

These canmittees made regulsrly inspections to dete~ine which ccnnunes and districhs . have attained the said 6"t ~ nd:al'ds •

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;:·;==============~=====;::=====-=:-=====•=====c:============-== . Year .. ' : • . Total • Note • • • . • . ...-. ... _....... .... _., ......... _ • -- s a -- I

_. ______ _... • -~-~-~~~~---~~~-• • •

:· l1umber of com- • • • • Kealth • canputed on the • • • • • . munes heaving • • . • stations • basis of the . • • • • • . lciet the stan- :1128 :2550 l}61 0: ru.n by : new odministrr . dard • • • . the peo- • tive division • • • • • . • • . .. ple 8660 • . . • • • •

• _ _.... ___ ..... ____ ,___~

• 1 • -- • ..................... • . • • • • : l'ltmber of d~s- • : • : Districts : • • • triote h~ving • 10. 6,: 14l: 430 : • • / . . met ttLe at an-:- : . : • . • • • • . diJrd • • • • • • • • • • • •

In rec~ut years , a rese4ilroh work into the use of traditional med1ciae is four communes has rec~en4ed tbe use of drugs prepared from 35 medicinal plants under tbe gui<lance of tbe Ministry ot' Public Health • ~hese druss l!re non-toxic and show necli~ib~e side-effects • They could CilUSe the disappearance or diminution of SJtnptoms in a relatively high pereentc:cge of Cises (in thE: clinical oo~i­

tion at the CCIJmlune) • Many recipes h.-.ve been exeined in t ::e ph~acologioal respect and t~e. reaul·ts agreed with -c he clinical indications •

~he Ministry of PubliC ·Heulth has worked out a progra:n to ensure thot in a 'few years• iiime each c :Jmnune will huve a~ secondary degree wor!c..er o1' tradition•l i!tedicine Jnd esch distric·t; one doctor , or college graduate

in t;aditioual medioine •

--

ANNEX 1

35 l'EDICINAL PL.AUTS USED FOR ,CURREUT r:r.EDICMJI'..ENTS IN 'r!-IE VILLAGES AND THE DISTILICTS '

-----p--------------·------~-----------------------------

25 llEDICINAL PLAnTS TREAT 7 CURRENT DISEASES

1. COW:ION COLD AHD INFLUENZA .:

- Bac ka (Me•tka arveasis Li~•) - Tu to "Perilla ocymoi(lf)S L:tJt•)

· - fuk tioi (Elsltoltzia cristata Willd) - I-Iuolll: ala.u (Oeimum sa.cturn LiJU) - Gua~ (ZiAtiber o!fici•alie Rose) - Cue koa (Ckr.ysa.tkemurn si•e•sis Sa~iae) - Sa {Cymbopo~o• ui tra-lim3 IIi••)

2. AUTIINFL.A.MMATION :

- Eim li~fut (Lo•icera Je.poaica) 'l'll.umb. - Sai dat (VIeldelia C~leudulaceae Less)

- Ke <tau ·~ (Xut1dum Strumariu:m L} - BO c6•K a.ak (Laotuca iadica Lia)

3. DIARRHOEA :

-Mad., (Plute.~o Major L.) - KAo sam (Brucea sumatraaa Mer.r.)

- Hoac kuo•t (Pot.osteme• CabliA BeAta.) - Rien!, ~Alpninia O!ficinarurn H~ce).

4. ANTERRITIS DYSEllTERY :

- Mo tam t:ae (Paederia. tomeatosa).

- Uuc ';toa tre.n«, (Holarrlte.aa btidyse.cteria Wall). - Co sua· (1~ to = larr.e leaves : Eupkorbia Pilulifera L).

(LanAo = small leaves : Eup~o~ia ~1ymi!olia Burm)

5. Rkurnatismal Artritia :

- Hy t!dem (Sie!,esbeckia Or~entalia L.)

- Ur~uu tat (Arcieyre.nt'kes Bidentetn Blu:oe)

- la lot (Piper Lolot G.n.c.)

.. 2 ..

6. Di~u ki11li ;

- Ick mau (Leonorus 'lteteropjcyllus) ffiV

- :tlg,a.i crtu (Artemiain Vulr:aris L.)

7. Couall :

- HWlf.. caa..n .. '!.t ( Coleus aror!f1ticus) - Re quat (Belamca.nda C'idnensis Lem).

10. SUPPLEI.EBI-:TARY LEDICINAL PLANTS

- Sb day (Pueraria Thoms old Bert tlt)

- 1r6lot O~laeal)lu.s Lati.to1Ja I,.)

- Tlti~n mol! ( l:sparatt,ns Luccidus Linae).

- IJllo ui)i (Eclipta Alba Hassk)

- Sam dai 'Ilana (Elentl-terlne Subapjcy'lle. Gaynep)

- Ca. f.ai leo (Sola.liW:1 Procumbena Lour).

- Dia .lie• (Kael!rp.fer.i.e Galai1ga LiAil). - Cam t\ia.o d!\y (Abrus Pre ca. torus Linn).

- Dau t~m (Morus Al~a Linn) - r:fnch. moa (Ophiope,2',on ,Japonicua).

TREAT NORMAL DISEASES OR SYMPTOMS BY ACUPUNCTURE AT THE DISTRICTS AND VILLAGES

1. Common cold and influenza•

Phong tri XI 20 Hop coc li 4 (Dai chuy XIU 14 Khue tri II 11 Ngoai quan X 5).

- High fev@r : Thieu thuong I 11 Cough ~!~~ khuyet II 7

- Sneezing s t;uffy nose ; N~&hinh huong II 20

2. Tonsi1itis, Pharyngit i § ;

- Thieu th~ong I 11, Hop coc II 4 (Khuc tri II ll. Liet khuyet 17, Dai chuy JUU l4), Noi dinh lH ~4 @iap xa III 6

- SQre throat Thien dot XIV 22

3. Bronchitis :

ANNEX 2

Thieu thuong I i1, D~i chuy XIII 14, Phe du VII 13 (Liet Khuyet I 7 Phong long III 40, Hop coc II 4)

4. Asthma

Suyen tuc 0 11, Dan trung XIV 17, Thien dot XIV 22 Phong long III 40.

5. Teethache:

Giep xa III 6, Hop coc II 4, Haquan III 7, Noi dinh III 44

6. Abdominal pain and diarrhoea

Tuc tam ly III 36, Thien khu III 25, Trung quan XIV 12, Ha cu hu III 38, Quan nguyen XIV 4.

If the diarrhoea isn't stopped, and cold the extrimities:

Moxa : Khi hai XIV 6, Than Khuyet XIV 8

7. Dysentery :

Tuc tam ly III36, Thien khu III 25, Quan nguyen XIV 4, Thuon Thuong cu hu III 37, Hop coc II 4.

8. Prolapse of the rectum:

Bach hoi XIII 20, Truong cuong XIII 8 (Tuc tam ly III 36, Thurn son VII 57)

9. Pain in the gastric region (Gastric symdrome).

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Tuc tam ly III 36, Trung quan XIV 12, Noi quam IX 6, Thai xung XII 3.

10. Enuresis

Trung cue XIV 3, Tam Am giao IV 6 (quan nguyen XIV 4, Bang quang du VII 28,

11. Retension of urine:

Trung do XII 6, Tam am giao IV 6, (quan nguyen XIV 4, Bang quang du VII 28

12. Oreillon:

E phong X 17, Giap xa Ill 6, Hop coc II 4, Giac ton X 20,

13. Headache :

- Vertical headache : Phong tri XI 20, XX, Thai duong 0 5, Duong phu XI 38; Thai xung XII 3, Dau duy III 8

- Frontal headache An duong 0 4; Hop coc II 4, dau duy III 8, Giai khe III 41;

- Occipital headache : Phong tri XI 20, Hau khe VI 3, Bach hoi XIII 20, Con lon VII 60,

14. Torticolis :

A thi (Acupuncture direct in the pain), Kien tinh XI 21, Doc du VII 16, Huyen chung XI 39.

15. Facial paralysis

Toan true VII 2, Tinh minh VII 1, Giap xaiii 6, Dia Thuong III 4, Hop coc II 4

16. Pain of the sciatic nerve :

Homa khieu XI 30, Uy trung VII 40, Con lon VII 60, Phong thi XI 31; Thau son VII 57, Duong lang tuyen XI 34,

17: Pain of the extremities

Upper extremities ; Duong coc VI 5, Duong tri X4, Duong khe II 5, A thi (Acupuncture direct in the pain), Kien agung II 15, Khuc tri II 11.

Lower extremities Duong phu XI 38, Giai khe III 4, Con lon VII 60, Hoen khieu XI 30, Cu lieu XI 29, Uy trung VII 40.

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18. Lumbago (Lumber pain) . . Than du VII 23, Yen du XIII 2, Uy trung VII 40, Hau khe

VI 3, A thi

19. Whooping cough :

Ngu te I 10, xich trach 1 5, Phong long III 40, Thien dot XIV 22

20. Higher fever with convulsion :

Thap tuyen 0 20, Bach hoi XII 20, Honh gian XII 2, Nhan trung XII 26

21. Urticaria

Khuc tri II 11, Huyet hai IV 10, Tuc tam ly III 36 (Tam am giao IV 6, Hop coc II 4)

22. Leucorrhea

Doi mach XI 26, Quan nguyen XIV 4, Tarn am giao IV 6, Trung cue XIV 3,

23. Obstruction of the milk ejection - Mastitis :

- Obstruction of the milk ejection: Kien tinh XI 21

- Mastitis : Kien tink XI 21, Nhu can III 18, Dan trung XIV 17 A thi (Acupuncture direct in the pain)

+ With purulentus ; An back IV 1, Thieu duong I 11

+ Pyomastitis : drainage incisio

+ With leucorrhea am giao IV 6.

moxa the point Quan nguyen XIV 4, Tern

In doing the acupunture : It's necesary to aspirate the milk.